Quantitative Whole Body Magnetic Resonance Imaging For The Tumor Burden And Treatment Response Assessment In Multiple Myeloma

Objective:Whole-body MRI was applied to quantitatively assess the tumor burden of MM patients,to determine the correlation between MRI parameters and prognostic biomarkers,and to further explore the feasibility of whole-body MRI parameters in the treatment response assessment of MM.Methods:Retrospective analysis of patients with newly diagnosed multiple myeloma confirmed by bone marrow aspiration and laboratory tests who attended the First Hospital of Jilin University from March 2019 to January 2023.All 102 patients who met the inclusion and exclusion criteria for this study underwent whole-body MRI before and at the end of the four-cycle treatment,and all patients underwent tumor burden study and treatment response assessment study and to evaluate treatment response.The region of interest(ROI)of each bone zone lesion was manually outlined in the Philips post-processing workstation(Intelli Space Portal,ISP)to obtain ADC values,FF values,and FF was calculated as FF=SI_F/(SI_F+SI_W).Results:In patients with diffuse/mixed infiltrative MM,FF values varied with the progression of ISS stage and R-ISS stage(P=0.014,P=0.003),and the differences were not statistically significant in DS stage;the differences in ADC values were not statistically significant among different DS stage,ISS stage,and R-ISS stage.In patients with focal infiltrative MM,the differences in ADC values and FF values were not statistically significant among different DS stages,ISS stages,and R-ISS stages.In patients with diffuse/mixed infiltrative MM,ADC values were negatively correlated with hemoglobin and not with other prognostic biomarkers.FF values were positively correlated with age and albumin and negatively correlated withβ2-microglobulin,bone marrow primitive and naive plasma cell ratio,ISS stage and IGH gene rearrangement.In patients with focal infiltrative MM,ADC values were negatively correlated with age and not with other prognostic biomarkers.And FF values did not correlate with all prognostic biomarkers.FF values in the deep response and non-deep response groups increased significantly before and after four cycles of treatment(P<0.05),and the amount of change was higher in the deep response group than in the non-deep response group(P=0.007),while the amount of change in ADC values was not statistically significant between the two groups.This study further demonstrated that FF values have good diagnostic efficacy for predicting deep treatment response and can be used as a quantitative biomarker for predicting deep treatment response.Conclusion:The whole-body MRI parameter FF values can be used as a quantitative biomarker for tumor burden in patients with diffuse/mixed infiltrative MM,and is correlated with prognostic.This study find that whole-body MRI is feasible in the assessment of MM efficacy,and FF is found to be a reliable quantitative biomarker in treatment response assessment and can predict deep treatment response.