Whole‑body diffusion‑weighted magnetic resonance imaging and apparent diffusion coefficient values as prognostic factors in multiple myeloma

Costachescu,Dan; Ionita,Ioana; Borsi,Ema-Cristina; Potre,Ovidiu; Potre,Cristina; Navolan,Dan-Bogdan; Blidisel,Alexandru; Ionita,Hortensia; Erimescu,Adelina; Pop,Gheorghe Nicusor; Malita,Daniel Claudiu

doi:10.3892/etm.2021.10259

Whole‑body diffusion‑weighted magnetic resonance imaging and apparent diffusion coefficient values as prognostic factors in multiple myeloma

Authors:
- Dan Costachescu
- Ioana Ionita
- Ema-Cristina Borsi
- Ovidiu Potre
- Cristina Potre
- Dan-Bogdan Navolan
- Alexandru Blidisel
- Hortensia Ionita
- Adelina Erimescu
- Gheorghe Nicusor Pop
- Daniel Claudiu Malita
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Affiliations: Department of Radiology, ‘Victor Babes’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania, Department of Hematology, ‘Victor Babes’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania, Department of Obstetrics and Gynecology, ‘Victor Babes’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania, Department of Surgery, ‘Victor Babes’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania, Center for Modeling Biological Systems and Data‑Analysis, Department of Functional Sciences, ‘Victor Babes’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania
Published online on: June 3, 2021 https://doi.org/10.3892/etm.2021.10259
Article Number: 827
Copyright: © Costachescu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Multiple myeloma (MM) is a neoplasm of the B lymphocytes characterized by the uncontrolled proliferation of a plasmocyte clone. Magnetic resonance imaging (MRI) remains the most sensitive and specific imaging method for the detection of bone marrow infiltration, before macroscopic bone changes are visible, with evidence that the detection rate and overall performance of MRI could be enhanced by applying diffusion‑weighted imaging (DWI). The aim of our research was to evaluate whether measuring apparent diffusion coefficient (ADC) values in newly diagnosed patients with MM could be a prognostic factor for the course of the disease and to ascertain whether there is any correlation with other prognostic factors in MM. A retrospective study was performed on a group of 32 patients with newly diagnosed MM that underwent at least two whole‑body (WB)‑MRIs; one before and one after induction therapy. Patients with advanced stage of disease showed an increased ADC value: Stage 2 vs. stage 1 (1.162 vs. 0.289, P=0.033), respectively, stage 3 vs. stage 1 (0.867 vs. 0.289, P=0.041). In addition, ADC values were inversely correlated with survival time: r=‑0.641, P<0.001. According to the multivariate linear regression model, we observed that for every point of ADC value (before treatment) the survival was decreased/reduced by 14.5 months. Moreover, bortezomib therapy predicted an increase in the survival length/duration by 7.9 months. Our regression equation proved to be a good fit for the model, explaining 57.8% of survival duration (adjusted R2=0.578). In conclusion, the negative prognostic factors associated with WB‑MRI are represented by high ADC values before treatment (for every point of ADC the survival was decreased by 14.5 months) and focal/diffuse marrow involvement.

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