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Apparent diffusion coefficient measurements of bone marrow infiltration patterns in multiple myeloma for the assessment of tumor burden – a feasibility study

Xing Xiong
Xing Xiong
, 
Yuzhu Ma
Yuzhu Ma
, 
Yao Dai
Yao Dai
, 
Chunhong Hu
Chunhong Hu
 and 
Yu Zhang
Yu Zhang
   | Nov 30, 2023
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Article Category: Research Article
Published Online: Nov 30, 2023
Page range: 455 - 464
Received: Jun 01, 2023
Accepted: Jul 22, 2023
DOI: https://doi.org/10.2478/raon-2023-0048
Keywords
© 2023 Xing Xiong et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

FIGURE 1.

Five bone marrow infiltration patterns of multiple myeloma patients and healthy controls: pure diffuse pattern (A, B), combined diffuse/focal pattern (C, D), focal pattern (E, F), salt and pepper pattern (G, H), normal pattern (I, J), healthy control (K, L). T1 weighted(WI) image (A, C, E, G, I, K), T2WI FS image (B, D, F, H, J, L).
Five bone marrow infiltration patterns of multiple myeloma patients and healthy controls: pure diffuse pattern (A, B), combined diffuse/focal pattern (C, D), focal pattern (E, F), salt and pepper pattern (G, H), normal pattern (I, J), healthy control (K, L). T1 weighted(WI) image (A, C, E, G, I, K), T2WI FS image (B, D, F, H, J, L).

FIGURE 2.

ROC curve analysis of discriminating multiple myeloma (MM) infiltration patterns of D from N by quantitative parameters of apparent diffusion coefficient (ADC).D = pure diffuse pattern; N = normal pattern
ROC curve analysis of discriminating multiple myeloma (MM) infiltration patterns of D from N by quantitative parameters of apparent diffusion coefficient (ADC).D = pure diffuse pattern; N = normal pattern

FIGURE 3.

ROC curve analysis of discriminating multiple myeloma (MM) infiltration patterns of N from healthy controls by quantitative parameters of apparent diffusion coefficient (ADC).N = normal
ROC curve analysis of discriminating multiple myeloma (MM) infiltration patterns of N from healthy controls by quantitative parameters of apparent diffusion coefficient (ADC).N = normal

FIGURE 4.

ROC curve analysis of discriminating healthy controls from multiple myeloma (MM) infiltration bone marrow by quantitative parameters of apparent diffusion coefficient (ADC).
ROC curve analysis of discriminating healthy controls from multiple myeloma (MM) infiltration bone marrow by quantitative parameters of apparent diffusion coefficient (ADC).

FIGURE 5.

Correlation analysis of bone marrow plasma cell ratio and mean apparent diffusion coefficient (ADCmean) values of diffuse infiltration patterns (N and D) in multiple myeloma (MM) patients.D = pure diffuse pattern; N = normal pattern
Correlation analysis of bone marrow plasma cell ratio and mean apparent diffusion coefficient (ADCmean) values of diffuse infiltration patterns (N and D) in multiple myeloma (MM) patients.D = pure diffuse pattern; N = normal pattern

Beta-2 microglobulin (β2-MG) characteristics of multiple myeloma (MM) patients with different magnetic resonance imaging (MRI) infiltration patterns

MRI pattern β2-MGa (mg/L) P
D M F SP N
D 9.3 ± 8.8 > 0.05 < 0.05 < 0.05 < 0.05
M 10.7 ± 13.9 < 0.05 < 0.05 < 0.05
F 4.4 ± 5.2 > 0.05 > 0.05
SP 2.9 ± 1.5 > 0.05
N 3.6 ± 2.4

The laboratory data of patients

Characteristics Number / mean ± standard deviation
MM subtypea
  lgG-K 28
  lgG-λ 21
  IgA-K 8
  lgA-λ 11
  IgM-K 1
  K 5
  λ 19
ISS stagea
  I/ II/ III 18/ 48/ 27
R-ISS stagea
  I/ II/ III 14/ 63/ 16
FISHa
  HRC/SRC 20 / 73
Plasma cells in BM (%)b 34.4 ± 22.3
Serum M proteinb 36.6 ± 23.7
Hemoglobinb 93.3 ± 23.1
Serum β2-MGb 6.6 ± 8.5
Serum creatinineb 127.3 ± 143.3
LDHb 197.9 ± 115.1

Hemoglobin characteristics of multiple myeloma (MM) patients with different magnetic resonance imaging (MRI) infiltration patterns

MRI pattern Haemoglobina (g/L) P
D M F SP N
D 77.0 ± 19.5 > 0.05 0.001 0.014 < 0.001
M 88.9 ± 21.1 > 0.05 > 0.05 0.009
F 100.8 ± 17.8 > 0.05 > 0.05
SP 97.6 ± 20.0 > 0.05
N 106.7 ± 23.8

Serum M protein characteristics of multiple myeloma (MM) patients with different magnetic resonance imaging (MRI) infiltration patterns

MRI pattern M proteina (g/L) P
D M F SP N
D 46.9 ± 27.6 > 0.05 > 0.05 > 0.05 < 0.05
M 49.8 ± 18.9 > 0.05 > 0.05 > 0.05
F 33.4 ± 20.8 > 0.05 > 0.05
SP 40.3 ± 18.8 < 0.05
N 19.9 ± 16.9

Plasma cells characteristics of multiple myeloma (MM) patients with different magnetic resonance imaging (MRI) infiltration patterns

MRI pattern plasma cellsa (%) P
D M F SP N
D 46.9 ± 20.1 > 0.05 > 0.05 < 0.05 < 0.001
M 50.3 ± 23.1 < 0.05 < 0.05 < 0.001
F 34.9 ± 17.8 > 0.05 < 0.05
SP 18.8 ± 8.3 < 0.05
N 15.7 ± 11.2
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