Abstract
BackgroundWhole-body diffusion-weighted imaging (WB-DWI) is a method for evaluating bone marrow infiltration in multiple myeloma (MM). This study seeks to elucidate the correlation between the apparent diffusion coefficient (ADC) value and some selected clinical parameters.MethodsA total of 101 Chinese patients with MM who had undergone WB-DWI from May 2017 to May 2019 were enrolled in this study. The ADC values of the MM lesions and the clinical parameters were quantified at the first (baseline) visit and after four-course induction chemotherapy. Multiple linear regression and logistic analyses were carried out to find the implicit inherent relationships within the patients’ data.ResultsThe paired Wilcoxon test showed that the ADC values at the baseline visit (ADC0) were significantly lower than the values after four-course induction chemotherapy (ADC4 c) (p < 0.001), including different therapeutic responses. The Revised International Staging System (RISS) stage, type of MM, and β2-microglobulin (β2-MG) were predictors of clinically significant increases or decreases in the ADC values (p < 0.05). Multiple linear regression showed that the ADC0 was negatively associated with β2-MG (p < 0.001) and immunoglobulin heavy chain gene rearrangement (p = 0.012), while the RISS Stage III (p = 0.001), type IgG λ (p = 0.005), and albumin were negatively associated with ADC4 c (p = 0.010). The impacts of the therapeutic response were associated with ADC0 and immunoglobulin heavy chain gene rearrangement (p < 0.001).ConclusionThe ADC values of WB-DWI may be associated with clinical parameters of MM including the fluorescence in situ hybridization result, and may be useful in the prognosis of patients with MM.Trial Registration: ChiCTR2000029587
Highlights
Whole-body diffusion-weighted imaging (WB-DWI) is a method for evaluating bone marrow infiltration in multiple myeloma (MM)
The relationship between the apparent diffusion coefficient (ADC) values of DWI imaging, which quantitatively reflect the disease burden of MM bone disease, and genetic variation has barely been clarified. It needs further verification whether the ADC value of MM bone lesions is related to genetic variation and whether the ADC value can map the microscopic characterization of genetics from the macroscopic point of view
The inclusion criteria were as follows: (1) patients aged between 18 and 70 years; (2) patients with a diagnosis of MM according to established diagnostic criteria; (3) patients who had undergone WB-DWI performed according to our standard MM protocol; (4) patients who had received autologous stem cell transplantation after induction chemotherapy; (5) patients who had received WB-DWI before and after four courses of induction chemotherapy
Summary
Whole-body diffusion-weighted imaging (WB-DWI) is a method for evaluating bone marrow infiltration in multiple myeloma (MM). The ADC value may likely provide more sensitive biomarkers for detecting changes in the microstructure that occur in the bone marrow, which may be a more accurate biomarker for the prediction of disease prognosis. Mutations with high levels of albumin and globulin means that the proliferation and secretion of tumor cells are more vigorous, which indirectly means more tumor cells and smaller intercellular spaces. These changes may lead to the limited diffusion of water molecules, relatively high DWI signal and low ADC value. The relationship between the ADC values of DWI imaging, which quantitatively reflect the disease burden of MM bone disease, and genetic variation has barely been clarified. It needs further verification whether the ADC value of MM bone lesions is related to genetic variation and whether the ADC value can map the microscopic characterization of genetics from the macroscopic point of view
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