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DCE-MRI 用于区分所有单克隆浆细胞疾病阶段，并与基于扩散加权 MRI/PET 的生物标志物在混合式同步全身 2-[18F]FDG-PET/MRI 成像方法中的相关性。

DCE-MRI to distinguish all monoclonal plasma cell disease stages and correlation with diffusion-weighted MRI/PET-based biomarkers in a hybrid simultaneous whole body-2-[18F]FDG-PET/MRI imaging approach.

机构信息

Nantes Université, Univ Angers, CHU Nantes, INSERM, CNRS, CRCI2NA, Médecine Nucléaire, F-44000, Nantes, France.

Nuclear Medicine Department, University Hospital, 1 Place Alexis Ricordeau, 44093, Nantes, France.

出版信息

Cancer Imaging. 2024 Jul 11;24(1):93. doi: 10.1186/s40644-024-00740-5.

DOI:10.1186/s40644-024-00740-5
PMID:38992707
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11241781/
Abstract

BACKGROUND

Dynamic contrast-enhanced-MRI (DCE-MRI) is able to study bone marrow angiogenesis in patients with multiple myeloma (MM) and asymptomatic precursor diseases but its role in the management of MM has not yet been established. The aims of this prospective study was to compare DCE-MRI-based parameters between all monoclonal plasma cell disease stages in order to find out discriminatory parameters and to seek correlations with other diffusion-weighted MRI and positron emission tomography (PET)-based biomarkers in a hybrid simultaneous whole-body-2-[18F]fluorodeoxyglucose (FDG)-PET/MRI (WB-2-[18F]FDG-PET/MRI) imaging approach.

METHODS

Patients with newly diagnosed Monoclonal gammopathy of undetermined significance (MGUS), smoldering multiple myeloma (SMM) or symptomatic MM according to international myeloma working group and underwent WB-2-[18F]FDG-PET/MRI imaging including bone marrow DCE sequences at the Nantes University Hospital were prospectively enrolled in this study before receiving treatment.

RESULTS

One hundred and sixty-seven patients (N = 167, mean age: 64 years ± 11 [Standard deviation], 66 males) were considered for the analysis. DCE-MRI-based Peak Enhancement Intensity (PEI), Time to PEI (TPEI) and their maximum intensity time ratio (MITR: PEI/TPEI) values were significantly different between the different monoclonal plasma cell disease stages, PEI values increasing and TPEI values decreasing progressively along the spectrum of plasma cell disorders, from MGUS stage to symptomatic multiple myeloma. PEI values were significantly higher in patients with diffuse bone marrow involvement (either in PET or in MRI images) than in those without diffuse bone marrow involvement, unlike TPEI values. PEI and TPEI values were not significantly different between patients with or without focal bone lesions.

CONCLUSION

Different DCE-MRI-based parameters (PEI, TPEI, MITR) could significantly differentiate all monoclonal plasma cell disease stages and complemented conventional MRI and PET-based biomarkers.

摘要

背景

动态对比增强磁共振成像（DCE-MRI）可用于研究多发性骨髓瘤（MM）和无症状前体疾病患者的骨髓血管生成，但它在 MM 治疗中的作用尚未确定。本前瞻性研究的目的是比较所有单克隆浆细胞疾病阶段的 DCE-MRI 相关参数，以找出具有鉴别能力的参数，并在 Hybrid 同时全身 2-[18F]氟代脱氧葡萄糖（FDG）-PET/MRI（WB-2-[18F]FDG-PET/MRI）成像方法中寻找与其他扩散加权 MRI 和正电子发射断层扫描（PET）相关生物标志物的相关性。

方法

本研究前瞻性纳入了在南特大学医院接受新诊断的意义未明单克隆丙种球蛋白血症（MGUS）、冒烟型多发性骨髓瘤（SMM）或根据国际骨髓瘤工作组标准的有症状 MM 且接受了 WB-2-[18F]FDG-PET/MRI 成像的患者，包括骨髓 DCE 序列。

结果

共 167 例患者（N=167，平均年龄：64 岁±11[标准差]，66 名男性）被纳入分析。不同单克隆浆细胞疾病阶段的 DCE-MRI 基础峰值增强强度（PEI）、PEI 达峰时间（TPEI）及其最大强度时间比（MITR：PEI/TPEI）值存在显著差异，PEI 值随着浆细胞疾病谱的进展而逐渐增加，TPEI 值逐渐降低，从 MGUS 阶段到有症状的多发性骨髓瘤。弥漫性骨髓受累（PET 或 MRI 图像中）患者的 PEI 值明显高于无弥漫性骨髓受累患者，而 TPEI 值则不然。有无局灶性骨病变的患者的 PEI 和 TPEI 值无显著差异。

结论

不同的 DCE-MRI 相关参数（PEI、TPEI、MITR）可显著区分所有单克隆浆细胞疾病阶段，并补充了常规 MRI 和 PET 相关生物标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/538c/11241781/e5c319ba34c5/40644_2024_740_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/538c/11241781/657316df74f9/40644_2024_740_Fig1_HTML.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/538c/11241781/4ed5565d3214/40644_2024_740_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/538c/11241781/e5c319ba34c5/40644_2024_740_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/538c/11241781/657316df74f9/40644_2024_740_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/538c/11241781/5dbce78d4bfe/40644_2024_740_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/538c/11241781/8a991b970e17/40644_2024_740_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/538c/11241781/ed7f481d5533/40644_2024_740_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/538c/11241781/86cf39007c38/40644_2024_740_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/538c/11241781/4ed5565d3214/40644_2024_740_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/538c/11241781/e5c319ba34c5/40644_2024_740_Fig7_HTML.jpg

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