<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec><h3>Background</h3>
<p>The purpose of our study was to explore and compare the tumor burden of different bone marrow infiltration patterns and evaluate the feasibility of apparent diffusion coefficient (ADC) value to identify patterns in multiple myeloma (MM).</p>
</sec>
<sec><h3>Patients and methods</h3>
<p>Ninety-three patients with newly diagnosed multiple myeloma and 23 controls had undergone routine magnetic resonance imaging (MRI) and diffusion-weighted MRI (DWI) from January 2019 to November 2020. Five bone marrow (BM) infiltration patterns were allocated according to routine MRI. The laboratory data and ADC values of patterns were analyzed and compared. ROC analysis was used to establish the best diagnostic ADC threshold value for identifying these patterns and distinguishing normal pattern from controls. Besides, the correlation between the ADC values of diffuse pattern and the plasma cells ratio was assessed.</p>
</sec>
<sec><h3>Results</h3>
<p>The values of hemoglobin, beta-2 microglobulin (β2-MG), plasma cell, M protein, the percentages of stage, high-risk fluorescence in situ hybridization, and ADC values showed significant difference among patterns. ADC<sub>mean</sub> at a specific value (368.5×10<sup>−6</sup> mm<sup>2</sup>/s) yielded a maximum specificity (95.5%) and sensitivity (92.0%) in diagnosing MM. A specific value (335.5×10<sup>−6</sup>mm<sup>2</sup>/s) yielded a maximum specificity (84.7%) and sensitivity (88.0%) in discriminating visually normal pattern in MM from controls. There was a moderate positive correlation between the plasma cells ratio and ADCs of diffuse infiltration patterns (r = 0.648, P &lt; 0.001).</p>
</sec>
<sec><h3>Conclusions</h3>
<p>The bone marrow infiltration patterns in MM patients can indicate the tumor burden and ADC value has the ability to discriminate these patterns objectively.</p>
</sec>
</abstract>

Background
The purpose of our study was to explore and compare the tumor burden of different bone marrow infiltration patterns and evaluate the feasibility of apparent diffusion coefficient (ADC) value to identify patterns in multiple myeloma (MM).

Patients and methods
Ninety-three patients with newly diagnosed multiple myeloma and 23 controls had undergone routine magnetic resonance imaging (MRI) and diffusion-weighted MRI (DWI) from January 2019 to November 2020. Five bone marrow (BM) infiltration patterns were allocated according to routine MRI. The laboratory data and ADC values of patterns were analyzed and compared. ROC analysis was used to establish the best diagnostic ADC threshold value for identifying these patterns and distinguishing normal pattern from controls. Besides, the correlation between the ADC values of diffuse pattern and the plasma cells ratio was assessed.

Results
The values of hemoglobin, beta-2 microglobulin (β2-MG), plasma cell, M protein, the percentages of stage, high-risk fluorescence in situ hybridization, and ADC values showed significant difference among patterns. ADCmean at a specific value (368.5×10−6 mm2/s) yielded a maximum specificity (95.5%) and sensitivity (92.0%) in diagnosing MM. A specific value (335.5×10−6mm2/s) yielded a maximum specificity (84.7%) and sensitivity (88.0%) in discriminating visually normal pattern in MM from controls. There was a moderate positive correlation between the plasma cells ratio and ADCs of diffuse infiltration patterns (r = 0.648, P < 0.001).

Conclusions
The bone marrow infiltration patterns in MM patients can indicate the tumor burden and ADC value has the ability to discriminate these patterns objectively.

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

The First Affiliated Hospital of Soochow University

Dushu Lake Hospital Affiliated to Soochow University

Radiology and Oncology

This work is licensed under the Creative Commons Attribution 4.0 International License.

Background
The purpose of our study was to explore and compare the tumor burden of different bone marrow infiltration patterns and evaluate the feasibility of...

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

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
multiple myeloma, bone marrow, infiltration pattern, tumor burden, apparent diffusion coefficient

© 2023 Xing Xiong et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Supplementary Material Details

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

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

Keywordsmultiple myeloma, bone marrow, infiltration pattern, tumor burden, apparent diffusion coefficient

© 2023 Xing Xiong et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Supplementary Material Details

Keywords
multiple myeloma, bone marrow, infiltration pattern, tumor burden, apparent diffusion coefficient