Multiple myeloma treatment response assessment with whole-body dynamic contrast-enhanced MR imaging
| Autor: | Karim Belhadj, Charles A. Cuenod, Mezri Maatouk, Alain Rahmouni, Frédérique Kuhnowski, Alain Luciani, Pauline Beaussart, Jean-François Deux, Chieh Lin, Corinne Haioun |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Adult
Male Cancer Research Treatment response medicine.medical_treatment Contrast Media Transplantation Autologous Statistics Nonparametric Autologous stem-cell transplantation Meglumine Bone Marrow Immunopathology Organometallic Compounds medicine Humans Radiology Nuclear Medicine and imaging Whole Body Imaging Multiple myeloma Aged Retrospective Studies Microvessel density Chemotherapy business.industry Cancer Middle Aged medicine.disease Control subjects Magnetic Resonance Imaging Mr imaging Dynamic contrast Treatment Outcome medicine.anatomical_structure ROC Curve Oncology Disease Progression Female Bone marrow Stem cell Multiple Myeloma Nuclear medicine business Whole body Stem Cell Transplantation |
| Zdroj: | Journal of Clinical Oncology. 28:8150-8150 |
| ISSN: | 1527-7755 0732-183X |
| Popis: | To compare posttreatment bone marrow changes at whole-body dynamic contrast material-enhanced magnetic resonance (MR) imaging with clinical response in patients with multiple myeloma (MM) and to determine if this technique can be used to assess treatment response in patients with MM.This study was approved by an institutional review board; all patients gave informed written consent. Thirty patients (21 men, nine women; mean age, 58 years +/- 10 [standard deviation]) underwent whole-body dynamic contrast-enhanced MR imaging before treatment, after induction chemotherapy (n = 30), and after autologous stem cell transplantation (ASCT) (n = 20). Maximal percentages of bone marrow (BME(max)) and focal lesion (FLE(max)) enhancement were assessed at each MR imaging examination. Clinical responses were determined on the basis of international uniform response criteria. Posttreatment changes in BME(max)and FLE(max)were compared with clinical response to therapy by using the Mann-Whitney U test. Receiver operating characteristic (ROC) analysis of posttreatment BME(max)was used to identify poor responders.Eleven of 30 patients were good responders to induction chemotherapy; 16 of 20 patients were good responders to ASCT. After induction chemotherapy, mean BME(max)differed between good and poor responders (94.3% vs 138.4%, respectively; P = .02). With the exclusion of results from six examinations with focal lesions in which a poor clinical response was classified but BME(max)had normalized, a posttreatment BME(max)of more than 96.8% had 100% sensitivity for the identification of poor responders (specificity, 76.9%; area under the ROC curve, 0.90; P = .0001). Mean FLE(max)after induction chemotherapy did not differ between good and poor responders. Mean timing (ie, the number of postcontrast dynamic acquisitions where FLE(max)was observed) was significantly delayed in good responders compared with poor responders (4.7 vs 2.9, P.0001). Post-ASCT MR imaging results correctly depicted all four clinically good responders whose disease subsequently progressed.With quantitative analysis of BME(max)and the timing of FLE(max), whole-body dynamic contrast-enhanced MR imaging can be used to assess treatment response in patients with MM. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|