Division of Haematology/Oncology, Department of Internal Medicine, Kameda Medical Centre, 929 Higashi-chou, Kamogawa, 296-8602, Japan.
Department of Radiology, Kameda Medical Centre, Kamogawa, Japan.
Eur Radiol. 2021 Aug;31(8):6136-6144. doi: 10.1007/s00330-021-07687-2. Epub 2021 Jan 26.
This study compared the tumor burden and prognostic impact of total diffusion volume (tDV) and total lesion glycolysis (TLG) in the same patients with newly diagnosed multiple myeloma (NDMM) simultaneously. We also examined the relationship between these imaging tumor volumes (TVs) and plasma cell (PC) TV in bone marrow (BM) specimens.
We retrospectively reviewed the data of 63 patients with newly diagnosed multiple myeloma (NDMM) from April 2016 to March 2018. tDV was calculated from whole-body diffusion-weighted imaging and TLG was calculated from the average standard uptake value and the metabolic tumor volume, respectively. Cellularity of BM hematopoietic tissue and the percentage of BM PCs were used as a reference of PC volume in the BM.
The Spearman correlation coefficient between tDV and TLG was moderate (ɤs = 0.588, p < 0.001) when PET false-negative patients were excluded. There were positive correlations between the BM plasma cell volume (BMPCV) and the imaging TVs (ɤs = 0.505, vs. tDV; and 0.464, vs. TLG). Patients with high tDV and high TLG, as determined by the receiver operating characteristic curve, had worse survival; moreover, patients with both high tDV and high TLG showed the worst prognosis (median progression-free and overall survival: 13.2 and 28.9 months, respectively).
Although tDV and TLG each reflected the total TV, in several cases, tDV and TLG were discrepant due to the biological features of each MM. It is important to use both modalities for complementary assessment of total tumor burden and biological characteristics in MM.
• Total diffusion volume (tDV) and total lesion glycolysis (TLG) reflect the total tumor volume and have prognostic value in patients with multiple myeloma (MM). • tDV and TLG could assess MM from different biological perspectives and should be considered for each patient individually.
本研究旨在比较同时患有新诊断多发性骨髓瘤（NDMM）的患者的总弥散体积（tDV）和总病变糖酵解（TLG）的肿瘤负担和预后影响。我们还研究了这些影像肿瘤体积（TVs）与骨髓（BM）标本中浆细胞（PC）TV 之间的关系。
我们回顾性分析了 2016 年 4 月至 2018 年 3 月期间 63 例新诊断多发性骨髓瘤（NDMM）患者的数据。全身弥散加权成像计算 tDV，平均标准摄取值和代谢肿瘤体积分别计算 TLG。BM 造血组织的细胞密度和 BM 中 PC 的百分比被用作 BM 中 PC 体积的参考。
当排除 PET 假阴性患者时，tDV 与 TLG 之间的 Spearman 相关系数为中度（ɤs=0.588，p<0.001）。BM 浆细胞体积（BMPCV）与影像 TVs 之间存在正相关（ɤs=0.505，与 tDV；0.464，与 TLG）。通过受试者工作特征曲线确定的高 tDV 和高 TLG 患者的生存较差；此外，具有高 tDV 和高 TLG 的患者表现出最差的预后（无进展生存期和总生存期的中位数分别为 13.2 和 28.9 个月）。
尽管 tDV 和 TLG 各自反映了总 TV，但在某些情况下，由于每种 MM 的生物学特征，tDV 和 TLG 可能存在差异。对于 MM 的总肿瘤负担和生物学特征的互补评估，使用这两种方式都很重要。
总弥散体积（tDV）和总病变糖酵解（TLG）反映了总肿瘤体积，在多发性骨髓瘤（MM）患者中具有预后价值。
tDV 和 TLG 可以从不同的生物学角度评估 MM，应根据每个患者的情况分别考虑。
