In vivo quantification of response to treatment in patients with multiple myeloma by 1H magnetic resonance spectroscopy of bone marrow.
OBJECTIVE
Magnetic resonance imaging (MRI) is the gold standard non-invasive technique to detect malignant disease in the bone marrow. Proton magnetic resonance spectroscopy (MRS) can be performed as a quick adjunct to routine spinal MRI. We performed proton MRS to patients with multiple myeloma (MM) at diagnosis and after treatment to investigate the possible correlation of MRS data with response to therapy.


METHODS
Twenty-one patients with newly diagnosed MM underwent combined MRI/MRS explorations of a transverse center section in the fifth lumbar vertebral body. MRS was acquired with STEAM and 40 ms TE. Areas of unsuppressed water and lipid resonances were used to calculate the lipid-to-water ratio (LWR).


RESULTS
No association was detected between initial LWRs and the clinical characteristics of patients. Post treatment MRS was available in 16 patients of whom 11 (69%) presented an LWR increase, this included all complete responders (8/8, 100%, P = 0.012). A post-treatment LWR value equal to or larger than one is proposed as a non-invasive marker of complete response to treatment.


CONCLUSIONS
Only patients responding to treatment presented a significant increase in bone marrow LWR after therapy. MRS may provide an adequate quantification of response to chemotherapy in patients with MM.
Oriol
Albert
A
Servei d'Hematologia Clínica, Institut Català d'Oncologia, Hospital Universitari Germans Trias i Pujol, Ctra. Canyet s/n, 08916 Badalona, Barcelona, Spain. aoriol@iconcologia.net
Valverde
Daniel
D
Capellades
Jaume
J
Cabañas
Miquel E
ME
Ribera
Josep-Maria
JM
Arús
Carles
C
D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D014408:Biomarkers, Tumor / Q000032:analysis*; D001853:Bone Marrow / Q000378:metabolism*; D005260:Female; D006801:Humans; D008055:Lipids / Q000032:analysis*; D008159:Lumbar Vertebrae / Q000378:metabolism; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis* / Q000188:drug therapy / Q000378:metabolism*; D011379:Prognosis; D011522:Protons; D016896:Treatment Outcome
D014408:Biomarkers, Tumor; D008055:Lipids; D011522:Protons