Eur Radiol: Can bone marrow ADC values guide clinical prediction of prognosis in patients with multiple myeloma?

Multiple myeloma (MM) is an incurable malignant tumor of the blood system.
the risk of disease progress and death is important for early identification of high-risk patients who require different treatment strategies.
a number of risk strated models have been proposed, some high-risk patients have not been identified.
for newly diagnosed MMs, a new model is needed to improve the risk layering approach.
bone lesions are an important feature of MM and have strong diagnostic and prognostic value.
magnetic resonance (especially systemic MRI) has high sensitivity to the display of nervous system and soft tissue, more accurate display of normal and tumor-soaked bone marrow, and no radiation.
systemic diffusion-weighted MRI (WB DW-MRI) imaging is a functional MR imaging that quantifies disease levels and therapeutic responses.
the surface diffusion coefficient (See diffusion coefficient, ADC) value is an important quantitative parameter described by DW-MRI.
, a recent study published in the journal European Radiology examined the relationship between baseline WB DW-MRI parameters (including ADC values) and progress-free lifetime (PFS) and total lifetime (OS) in newly diagnosed MM patients, clarifying the prognostic value of ADC (esoteric dispersion coefficient) as an important quantitative parameter for dispersive weighted MRI for multiple myeloma (MM).
this study is a forward-looking single-center study that includes 114 consecutive newly diagnosed MM patients, each with a full-body dispersion weighted MRI (WB DW-MRI) scan at the baseline.
clinical and MRI parameters when using single-factor and multi-factor methods to analyze baselines to determine independent risk factors for progress-free lifetime (PFS) and total lifetime (OS).
five different DW-MRI types were observed, with a representative background bone marrow ADC value averaging 0.4662 ± 0.1939 × 10-3 mm2/s.
50.2 months of follow-up (range 15.7-75.8 months), 24 patients died and 7 lost follow-up.
representative background bone marrow ADC value is PFS (HR 4.664; 95% confidence interval (CI) 1.138-19.121; p - 0.032) and total survival rate (HR 14.130; 95% confidence interval 1.544 - -129.299; p - 0.019) independent risk factor.
when using single-factor analysis, DW-MRI shows a normal/pepper-salt-type correlation with PFS (p s 0.035), but there is no statistical correlation in multi-factor Cox regression analysis.
FS(a) and OS(b) survival curves, which represent a truncated value of 0.45×10-3 mm2/s for patients with different DW-MRI models of PFS(a) and OS(b) survival curve bone marrow ADC average predictive multiple myeloma PFS and OS, indicating that DW-MRI has a predictive role in the risk stratation of new MM patients at baseline.