title: Diagnostic performance of whole-body MRI for the detection of persistent or relapsing disease in multiple myeloma after stem cell transplantation.
abstract: OBJECTIVE
  To compare the diagnostic performance of whole-body MRI (WBMRI) with haematological parameters for detecting persistent or relapsing disease in patients with multiple myeloma after stem cell transplantation.
  
  
  METHODS
  Sixty-six WBMRI acquisitions were performed in 33 patients with multiple myeloma at two time points after stem cell transplantation. Extent of disease and inter-test dynamics of intra- and extramedullary myeloma manifestations were compared (kappa statistics) with Uniform Response Criteria, comprising haematological parameters.
  
  
  RESULTS
  Using data from 66 sequential WBMRI acquisitions in 33 patients, 10 patients (30.3 %) were classified as having progressive disease and 23 (69.7 %) as being in remission. Eight (80 %) of the ten patients with progressive disease revealed intramedullary lesions, and two patients (20 %) had intra- and extramedullary lesions. WBMRI and laboratory tests were concordant in 26/33 (78.8 %) patients. We found an agreement of 51.2 %, 95 % confidence interval 19.8 %-82.6 %, between results from WBMRI and haematological parameters. WBMRI had a sensitivity of 63.6 %, specificity of 86.4 %, PPV of 70.0 %, NPV of 82.6 % and accuracy of 78.8 % for detection of remission.
  
  
  CONCLUSIONS
  WBMRI allows the detection and exact localisation of intra- and extramedullary myeloma manifestations after stem cell transplantation, but shows only moderate agreement with routinely performed laboratory tests for determination of remission.
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany. p.bannas@uke.de
authors.forename: Peter
authors.initials: P
authors.lastname: Bannas
authors.forename: Hannah B
authors.initials: HB
authors.lastname: Hentschel
authors.forename: Thorsten A
authors.initials: TA
authors.lastname: Bley
authors.forename: András
authors.initials: A
authors.lastname: Treszl
authors.forename: Christine
authors.initials: C
authors.lastname: Eulenburg
authors.forename: Thorsten
authors.initials: T
authors.lastname: Derlin
authors.forename: Jin
authors.initials: J
authors.lastname: Yamamura
authors.forename: Gerhard
authors.initials: G
authors.lastname: Adam
authors.forename: Thomas
authors.initials: T
authors.lastname: Stübig
authors.forename: Nicolaus
authors.initials: N
authors.lastname: Kröger
authors.forename: Christoph
authors.initials: C
authors.lastname: Weber
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000473:pathology* / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000517:prevention & control*; D033581:Stem Cell Transplantation; D016896:Treatment Outcome; D051598:Whole Body Imaging / Q000379:methods*