Zhang Bei, Bian Bingyang, Zhang Yanjiao, Zhang Li, Zhang Rongkui, Wang Jiping
Department of Radiology, First Hospital of Jilin University, Changchun, China.
Department of Hematology, First Hospital of Jilin University, Changchun, China.
Front Oncol. 2022 Mar 4;12:780078. doi: 10.3389/fonc.2022.780078. eCollection 2022.
Diffusion-weighted whole-body MRI (DW-MRI) is increasingly used to evaluate bone diseases of multiple myeloma (MM), but there is lack of quantitative indicator for DW-MRI to reflect the prognosis of MM. Apparent diffusion coefficient (ADC) values in DW-MRI has potential correlations between some indexes of MM, but the influence of ADC on MM survival needs to be further verified.
A total of 381 newly diagnosed MM patients were enrolled in the study to analyze the effect of ADC values in DW-MRI on progression-free survival (PFS) and overall survival (OS). The Kaplan-Meier method was used to perform univariate survival analysis, and the Cox proportional hazards model was used for multivariate analysis. In addition to the ADC value, genetic and serological indexes were also included.
The survivals were observed in univariate ADC stratification with median PFS of 52.0, 45.0, 34.0, and 26.0 months (the unit of ADC value was 10 mm/s; the ADC ranges were ADC < 0.4886, 0.4886 ≤ ADC < 0.6545, 0.6545 ≤ ADC < 0.7750, and ADC ≥ 0.7750; 95% CI, 43.759-62.241, 46.336-53.664, 39.753-46.247, and 27.812-32.188). The OS were 81.0, 61.0, 47.0, and 36.0 months ( < 0.001; 95% CI, 71.356-82.644, 67.630-70.370, 57.031-60.969, and 36.107-43.893). In Cox proportional hazards model, the ADC value was considered to be an independent risk factor affecting PFS and OS of MM (both < 0.001).
This study supports that ADC in DW-MRI may independently stratify MM patients and better predict their prognosis. The combined use of DW-MRI and other parameters allows more accurate evaluation of MM survival.
http://www.chictr.org.cn/showproj.aspx?proj=49012, ChiCTR2000029587.
扩散加权全身磁共振成像（DW-MRI）越来越多地用于评估多发性骨髓瘤（MM）的骨病，但缺乏DW-MRI的定量指标来反映MM的预后。DW-MRI中的表观扩散系数（ADC）值与MM的一些指标之间存在潜在关联，但ADC对MM生存的影响尚需进一步验证。
本研究共纳入381例新诊断的MM患者，分析DW-MRI中ADC值对无进展生存期（PFS）和总生存期（OS）的影响。采用Kaplan-Meier法进行单因素生存分析，Cox比例风险模型进行多因素分析。除ADC值外，还纳入了基因和血清学指标。
在单因素ADC分层中观察到的生存期，中位PFS分别为52.0、45.0、34.0和26.0个月（ADC值单位为10⁻³mm²/s；ADC范围分别为ADC < 0.4886、0.4886≤ADC < 0.6545、0.6545≤ADC < 0.7750和ADC≥0.7750；95%CI，43.759 - 62.241、46.336 - 53.664、39.753 - 46.247和27.812 - 32.188）。OS分别为81.0、61.0、47.0和36.0个月（P < 0.001；95%CI，71.356 - 82.644、67.630 - 70.370、57.031 - 60.969和36.107 - 43.893）。在Cox比例风险模型中，ADC值被认为是影响MM患者PFS和OS的独立危险因素（均P < 0.001）。
本研究支持DW-MRI中的ADC可能独立地对MM患者进行分层并更好地预测其预后。联合使用DW-MRI和其他参数可更准确地评估MM的生存期。
http://www.chictr.org.cn/showproj.aspx?proj=49012，ChiCTR2000029587 。
