Prospective Evaluation of Whole-Body MRI versus FDG PET/CT for Lesion Detection in Participants with Myeloma.
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Authors
Messiou, C
Porta, N
Sharma, B
Levine, D
Koh, D-M
Boyd, K
Pawlyn, C
Riddell, A
Downey, K
Croft, J
Morgan, V
Stern, S
Cheung, B
Kyriakou, C
Kaczmarek, P
Winfield, J
Blackledge, M
Oyen, WJG
Kaiser, MF
Porta, N
Sharma, B
Levine, D
Koh, D-M
Boyd, K
Pawlyn, C
Riddell, A
Downey, K
Croft, J
Morgan, V
Stern, S
Cheung, B
Kyriakou, C
Kaczmarek, P
Winfield, J
Blackledge, M
Oyen, WJG
Kaiser, MF
Document Type
Journal Article
Date
2021-09-01
Date Accepted
2021-09-01
Abstract
Purpose To compare disease detection of myeloma using contemporary whole-body (WB) MRI and fluorine 18 (18F) fluorodeoxyglucose (FDG) PET/CT protocols and to correlate imaging with laboratory estimates of disease burden, including molecular characteristics. Materials and Methods In this observational, prospective study, participants were recruited from November 2015 to March 2018 who had a diagnosis of myeloma, who were planned to undergo chemotherapy and autologous stem cell transplantation, and who underwent baseline WB-MRI and FDG PET/CT (ClinicalTrials.gov identifier NCT02403102). Baseline clinical data, including genetics, were collected. Paired methods were used to compare burden and patterns of disease. Results Sixty participants (mean age, 60 years ± 9 [standard deviation]; 35 men) underwent baseline WB-MRI and FDG PET/CT. WB-MRI showed significantly higher detection for focal lesions at all anatomic sites (except ribs, scapulae, and clavicles) and for diffuse disease at all sites. Two participants presented with two or more focal lesions smaller than 5 mm only at WB-MRI but not FDG PET/CT. Participants with diffuse disease at MRI had higher plasma cell infiltration (percentage of nucleated cells: median, 60% [interquartile range {IQR}, 50%-61%] vs 15% [IQR, 4%-50%]; P = .03) and paraprotein levels (median, 32.0 g/L [IQR, 24.0-48.0 g/L] vs 20.0 g/L [IQR, 12.0-22.6 g/L]; P = .02) compared with those without diffuse disease. All genetically high-risk tumors showed diffuse infiltration at WB-MRI. Conclusion WB-MRI helped detect a higher number of myeloma lesions than FDG PET/CT, and diffuse disease detected at WB-MRI correlated with laboratory measures of disease burden and molecular markers of risk. Keywords: MR-Imaging, Skeletal-Appendicular, Skeletal-Axial, Bone Marrow, Hematologic Diseases, Oncology Clinical trial registration no. NCT02403102. Supplemental material is available for this article. © RSNA, 2021.
Citation
Radiology: Imaging Cancer, 2021, 3 (5), pp. e210048 -
Source Title
Radiology: Imaging Cancer
Publisher
RADIOLOGICAL SOC NORTH AMERICA (RSNA)
ISSN
2638-616X
eISSN
2638-616X
2638-616X
2638-616X
Collections
Research Team
Clin Trials & Stats Unit
RMH Honorary Faculty
Myeloma Biol Therap
Appl Phys in Clinical MRI
Computational Imaging
Myeloma Molecular Therapy
RMH Honorary Faculty
Myeloma Biol Therap
Appl Phys in Clinical MRI
Computational Imaging
Myeloma Molecular Therapy