The Diagnostic Value Of Dixon And DKI Technique In Multiple Myeloma

Objective: Measurement of quantitative indicators fat fraction(fat fraction,FF),average dispersion coefficient(mean diffusion coefficient,MD),average dispersion kurtosis(mean kurtosis,MK)and apparent diffusion coefficient of ADC(apparent diffusion coefficient,ADC)from Dixon(chemical shift – encoding water – fat imaging,Dixon)and DKI(diffusion kurtosis imaging,DKI)technology in patients with multiple myeloma,aiming to study the value of MRI quantitative indicators in the diagnosis of Bone lesions in multiple myeloma,to explore the feasibility of Dixon and DKI technology in predicting the clinical stage of MM,to observe the correlation between MR quantitative indicators and laboratory indicators,and to provide a evidence for the non-invasive diagnosis and Prognostic evaluationof myeloma.Methods: A total of newly diagnosed multiple myeloma patients(n=40,MM group)and healthy contrasts(n=16,control group)admitted to The Affiliated Hospital of Qingdao University from June 2020 to January 2022 were enrolled.All myeloma patients were divided into three groups(ISS Ⅰ-III)according to the international staging System(ISS).Dixon technique and DKI technique were used to scan lumbar vertebrae in MM group and control group.The images were quantitatively analyzed by post-processing software,and the values of FF,MD,MK and ADC were obtained.T test and Mann-Whitney U test were used to compare the difference of quantitative parameters between MM group and control group.ANOVA and K-WH tests were used to compare the clinical and laboratory indexes(sex,age,ISS stage,percentage of myeloplasmic cells(%),β2-microglobulin(mg/L),serum albumin(g/L),d-dimer(ng/m L),serum calcium value(mmol/L),and corrected serum calcium value(mm),creatinine(μmol/L),alkaline phosphatase(U/L),M protein(g/L),erythrocyte sedimentation rate(mm/h),hemoglobin(g/L)and quantitative parameters(FF,MD,MK,ADC)of patients in ISS stage Ⅰ to III.Area Under The curve(AUC)of Receiver Operator characteristic Curve(ROC)was used to evaluate the diagnostic efficacy of MR quantitative parameters in differentiating MM group,control group and different stages.Spearman and Pearson correlation coefficients analysis were used to analyze the correlation between laboratory indicators and quantitative parameters of FF,MD,MK and ADC.Results: Baseline clinical data of MM patients:(1)There was no significant difference in age and gender between MM and control group;(2)There were no significant differences in age and sex between groups(ISS Ⅰ-III)(P > 0.05).(2)Comparison of MR quantitative parameters: FF and MK values in MM group were significantly lower than those in control group,while MD and ADC values were significantly higher than those in control group,and the differences were statistically significant.The differences of FF in ISS Ⅰ,Ⅱ,ISS Ⅰ and III,MK in ISS Ⅰ and III,ADC in ISS Ⅱ and III was statistically significant,but there was no statistically significant difference between MD groups.(3)Comparison of diagnostic efficacy of MR quantitative parameters: FF value had the highest diagnostic efficacy when differentiating between MM and control group,and AUC value of area under curve was 0.953(95%CI: 0.905-1.000).For ISS Ⅰ and Ⅱ stage,FF had the highest efficiency(AUC 0.971(95%CI: 0.915-1.000),and for ISS Ⅰ and III stage,FF had the highest efficiency(AUC 0.944(95%CI: 0.944).0.836-1.000),the highest ADC efficiency was 0.787(95%CI: 0.624-0.950).(4)Correlation analysis of laboratory indicators:(1)Comparison of laboratory indicators in different stages: β2-microglobulin(mg/L)and erythrocyte sedimentation rate(mm/h)values between groups were statistically significant;(2)Correlation between MR quantitative parameters and laboratory indicators: There was significant negative correlation between MK and β2 microglobulin,serum calcium value and corrected serum calcium value(correlation coefficients were-0.431,-0.354,-0.334,respectively),and significant positive correlation between ADC and β2 microglobulin,serum calcium value and corrected serum calcium value(correlation coefficients were 0.370,0.338,0.539,respectively).Conclusion: Lumbar FF,MD,MK and ADC values can be used for the diagnosis of MM bone lesions.Lumbar FF,MK and ADC values can be used to determine the clinical stage of MM.There were negative and positive correlations between lumbar MK and ADC values and β2 microglobulin,serum calcium and corrected serum calcium.These results suggest that Dixon and DKI quantitative parameters can be used as new non-invasive diagnostic parameters,and provide theoretical evidence for the diagnosis of bone disease and prognosis evaluation in patients with MM.