Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacherstr 6, 97080 Würzburg, Germany.
Department of Nuclear Medicine, University Hospital Würzburg, Oberdürrbacherstr 6, 97080 Würzburg, Germany.
Eur J Radiol. 2022 Oct;155:110493. doi: 10.1016/j.ejrad.2022.110493. Epub 2022 Aug 19.
We tested a novel multi-parametric (mp) whole body (WB)-MRI evaluation algorithm for medullary lesions in comparison to positron emission tomography (PET) radiotracers F-fluorodeoxyglucose (F-FDG) and C-methionine (C-MET).
This retrospective single-center study included 44 MM patients, who received both F-FDG-PET and WB-MRI within ten days. MRI classified focal lesions as vital when showing 1) significant diffusion-restriction, 2) a fat fraction (FF) less than 20 % and 3) homogenous hypointensity on T2-weighted images. On a lesion-by-lesion level the findings were compared to F-FDG PET by using a 5-point scoring system (analogous to the Deauville score [DS]). In 24/44 (55 %) patients additional comparison to C-MET PET was available.
Among two radiologists, an excellent inter-observer reliability for mpWB-MRI in a total of 84 medullary lesions was observed (ICC = 1, k = 1, p <.01). 16/17 (94.1 %) MRI-classified vital lesions had a DS of 4 or 5 on either F-FDG-PET or C-MET-PET. MRI-rated non-vital lesions correlated with PET-based DS ≤ 3. When results of mpWB-MRI were compared to F-FDG, a fair inter-observer agreement was recorded (ICC = 0.52, k = 0.53, p <.01), while for C-MET, an excellent concordance rate was achieved (ICC = 0.81, k = 0.79, p <.01).
The proposed mpWB-MRI interpretation algorithm allowed to assess tumor activity of myeloma lesions with high inter-observer reproducibility. We observed a substantial concordance between the mpWB-MRI classification of lesions and PET assessment based on a semi-automatically calculated 5-point scoring system analogous to the Deauville scores.
我们测试了一种新的多参数（mp）全身（WB）-MRI 评估算法，用于比较正电子发射断层扫描（PET）放射性示踪剂 F-氟脱氧葡萄糖（F-FDG）和 C-蛋氨酸（C-MET）的骨髓病变。
这项回顾性单中心研究纳入了 44 例 MM 患者，他们在 10 天内接受了 F-FDG-PET 和 WB-MRI 检查。MRI 将有以下表现的局灶性病变归类为有活性：1）明显的弥散受限，2）脂肪分数（FF）小于 20%，3）T2 加权图像上呈均匀低信号。在病变层面上，使用 5 分评分系统（类似于 Deauville 评分[DS]）与 F-FDG PET 进行比较。在 24/44（55%）例患者中，还可与 C-MET PET 进行比较。
在两位放射科医生中，总共 84 个骨髓病变的 mpWB-MRI 具有极好的观察者间可靠性（ICC=1，k=1，p<.01）。16/17（94.1%）MRI 分类为有活性的病变在 F-FDG 或 C-MET-PET 上的 DS 为 4 或 5。MRI 分级为无活性病变与基于 PET 的 DS≤3 相关。当将 mpWB-MRI 的结果与 F-FDG 进行比较时，记录到了中等程度的观察者间一致性（ICC=0.52，k=0.53，p<.01），而对于 C-MET，实现了极好的一致性率（ICC=0.81，k=0.79，p<.01）。
提出的 mpWB-MRI 解读算法能够以高观察者间可重复性评估骨髓瘤病变的肿瘤活性。我们观察到病变的 mpWB-MRI 分类与基于半自动化计算的 5 分评分系统（类似于 Deauville 评分）的 PET 评估之间存在很大的一致性。
