• Academic radiology · Jul 2018

    Discriminating Depth of Response to Therapy in Multiple Myeloma Using Whole-body Diffusion-weighted MRI with Apparent Diffusion Coefficient: Preliminary Results From a Single-center Study.

    • Chao Wu, Juan Huang, Wen-Bin Xu, Yong-Jing Guan, Hua-Wei Ling, Jian-Qing Mi, and Hua Yan.
    • Department of Hematology, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, No.197 Ruijin 2nd Road, Huangpu District, Shanghai 200025, China; Shanghai Jiao Tong University School of Medicine, Shanghai, China.
    • Acad Radiol. 2018 Jul 1; 25 (7): 904-914.

    Rationale And ObjectivesThis study aimed to measure apparent diffusion coefficient (ADC) in Chinese patients with newly diagnosed multiple myeloma by whole-body diffusion-weighted magnetic resonance imaging (WB-DWI MRI) and assess the diagnostic accuracy of ADC in the discrimination of deep response to induction chemotherapy.Materials And MethodsSeventeen patients underwent WB-DWI MRI before and after induction chemotherapy (week 20). DWI images and ADC maps were produced and 89 regions of interest were chosen. ADC percent changes were compared between deep (complete response or very good partial response) and non-deep responders (partial response, minimal response, stable disease, or progressive disease) as International Myeloma Working Group criteria. Diagnostic accuracy of ADC was calculated using specific cut offs. Predictive positive value of ADC was calculated to predict deep response to consolidation therapy.ResultsLesions reduced in size and number and signal intensity decreased in follow-up DWI, which did not differ between deep and non-deep responders. ADC percent changes were significantly higher in deep responders (36.79%) than in non-deep responders (11.50%) after induction therapy (P = .02) in per lesion analysis. ADC percent increases by 46.96%, 78.0% yielded specificity at 81.4%, 90.7% in discriminating deep response to induction therapy. Predictive positive value predicting deep response to consolidation therapy was 60.5% by using ADC cutoff >1.00 × 10-3 mm2/s at week 20.ConclusionsADC from WB-DWI MRI increased remarkably in patients who achieved deep response at the end of induction chemotherapy, which represented a confirmatory diagnostic tool to discriminate deep response to induction therapy for patients with multiple myeloma. ADC may have a potential to predict deep response to consolidation therapy.Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

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