Comparison of qualitative and quantitative CT and MRI parameters for monitoring of longitudinal spine involvement in patients with multiple myeloma
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Comparison of qualitative and quantitative CT and MRI parameters for monitoring of longitudinal spine involvement in patients with multiple myeloma. / Horger, M; Fritz, J; Thaiss, W M; Ditt, H; Weisel, K; Haap, M; Kloth, Christopher.
in: SKELETAL RADIOL, Jahrgang 47, Nr. 3, 03.2018, S. 351-361.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Comparison of qualitative and quantitative CT and MRI parameters for monitoring of longitudinal spine involvement in patients with multiple myeloma
AU - Horger, M
AU - Fritz, J
AU - Thaiss, W M
AU - Ditt, H
AU - Weisel, K
AU - Haap, M
AU - Kloth, Christopher
PY - 2018/3
Y1 - 2018/3
N2 - PURPOSE: To compare qualitative and quantitative computed tomography (CT) and magnetic resonance imaging (MRI) parameters for longitudinal disease monitoring of multiple myeloma (MM) of the axial skeleton.MATERIALS AND METHODS: We included 31 consecutive patients (17 m; mean age 59.20 ± 8.08 years) with MM, who underwent all baseline (n = 31) and at least one or more (n = 47) follow-up examinations consisting of multi-parametric non-enhanced whole-body MRI (WBMRI) and non-enhanced whole-body reduced-dose thin-section MDCT (NEWBMDCT) between 06/2013 and 09/2016. We classified response according to qualitative CT criteria into progression (PD), stable(SD), partial/very good partial (PR/VGPR) and complete response(CR), grouping the latter three together for statistical analysis because CT cannot reliably assess PR and CR. Qualitative MR-response criteria were defined and grouped similarly to CT using longitudinal quantification of signal-intensity changes on T1w/STIR/ T2*w and calculating ADC-values. Standard of reference was the hematological laboratory (M-gradient).RESULTS: Hematological response categories were CR (14/47, 29.7%), PR (2/47, 4.2%), SD (16/47, 34.0%) and PD (15/47, 29.9%). Qualitative-CT-evaluation showed PD in 12/47 (25.5%) and SD/PR/VGPR/CR in 35/47 (74.5%) cases. These results were confirmed by quantitative-CT in all focal lytic lesions (p < 0.001). Quantitative-CT at sites with diffuse bone involvement showed significant increase of maximum bone attenuation (p < 0.001*) and significant decrease of minimal bone (p < 0.002*) in the SD/PR/VGPR/CR group. Qualitative MRI showed PD in 14/47 (29.7%) and SD/PR/VGPR/CR in 33/47 (70.3%). Quantitative MRI diagnosis showed a statistically significant decrease in signal intensity on short tau inversion recovery sequences (STIR) in bone marrow in patients with diffuse bone marrow involvement achieving SD/PR/VGPR/CR (p < 0.001*).CONCLUSION: Imaging response monitoring using MRI is superior to CT only if qualitative parameters are used, whereas there was no definite benefit from using quantitative parameters with either CT or MRI.
AB - PURPOSE: To compare qualitative and quantitative computed tomography (CT) and magnetic resonance imaging (MRI) parameters for longitudinal disease monitoring of multiple myeloma (MM) of the axial skeleton.MATERIALS AND METHODS: We included 31 consecutive patients (17 m; mean age 59.20 ± 8.08 years) with MM, who underwent all baseline (n = 31) and at least one or more (n = 47) follow-up examinations consisting of multi-parametric non-enhanced whole-body MRI (WBMRI) and non-enhanced whole-body reduced-dose thin-section MDCT (NEWBMDCT) between 06/2013 and 09/2016. We classified response according to qualitative CT criteria into progression (PD), stable(SD), partial/very good partial (PR/VGPR) and complete response(CR), grouping the latter three together for statistical analysis because CT cannot reliably assess PR and CR. Qualitative MR-response criteria were defined and grouped similarly to CT using longitudinal quantification of signal-intensity changes on T1w/STIR/ T2*w and calculating ADC-values. Standard of reference was the hematological laboratory (M-gradient).RESULTS: Hematological response categories were CR (14/47, 29.7%), PR (2/47, 4.2%), SD (16/47, 34.0%) and PD (15/47, 29.9%). Qualitative-CT-evaluation showed PD in 12/47 (25.5%) and SD/PR/VGPR/CR in 35/47 (74.5%) cases. These results were confirmed by quantitative-CT in all focal lytic lesions (p < 0.001). Quantitative-CT at sites with diffuse bone involvement showed significant increase of maximum bone attenuation (p < 0.001*) and significant decrease of minimal bone (p < 0.002*) in the SD/PR/VGPR/CR group. Qualitative MRI showed PD in 14/47 (29.7%) and SD/PR/VGPR/CR in 33/47 (70.3%). Quantitative MRI diagnosis showed a statistically significant decrease in signal intensity on short tau inversion recovery sequences (STIR) in bone marrow in patients with diffuse bone marrow involvement achieving SD/PR/VGPR/CR (p < 0.001*).CONCLUSION: Imaging response monitoring using MRI is superior to CT only if qualitative parameters are used, whereas there was no definite benefit from using quantitative parameters with either CT or MRI.
KW - Adult
KW - Aged
KW - Disease Progression
KW - Female
KW - Humans
KW - Magnetic Resonance Imaging
KW - Male
KW - Middle Aged
KW - Multiple Myeloma
KW - Retrospective Studies
KW - Spinal Neoplasms
KW - Tomography, X-Ray Computed
KW - Whole Body Imaging
KW - Comparative Study
KW - Journal Article
U2 - 10.1007/s00256-017-2827-y
DO - 10.1007/s00256-017-2827-y
M3 - SCORING: Journal article
C2 - 29222688
VL - 47
SP - 351
EP - 361
JO - SKELETAL RADIOL
JF - SKELETAL RADIOL
SN - 0364-2348
IS - 3
ER -
