title: Prognostic significance of whole-body MRI in patients with monoclonal gammopathy of undetermined significance.
abstract: Radiological skeletal survey or computed tomography are currently applied to assess bone diseases in patients with monoclonal plasma cell disorders. Whole-body magnetic resonance imaging (whole-body MRI) allows detecting the infiltration of clonal cells in nearly the whole bone marrow compartment even before bone destruction has occurred. Those MRI results (i.e., patterns of bone marrow infiltration) have been demonstrated to be of prognostic significance in patients with symptomatic as well as asymptomatic multiple myeloma. We have therefore analyzed the findings of whole-body MRI in 137 consecutive individuals with monoclonal gammopathy of undetermined significance (MGUS). A focal infiltration pattern was detected in 23.4% of patients. Presence and number of focal lesions as well as value of M-Protein were of independent prognostic significance for progression into a symptomatic disease requiring systemic treatment (P=0.02; P<0.0001 and P=0.0005, respectively). Lower homogeneous signal intensities in T1-weighted images were related to a physiologically higher bone marrow cellularity in younger individuals (P=0.002). We conclude that whole-body MRI identifies patients with focal accumulations of presumably monoclonal cells in bone marrow with prognostic impact concerning the risk of progression into symptomatic disease.
authors: 1] Department of Hematology and Oncology, University of Heidelberg, Heidelberg, Germany [2] Department of Radiology, German Cancer Research Center, Heidelberg, Germany.
authors: J
authors: J
authors: Hillengass
authors: Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany.
authors: M-A
authors: MA
authors: Weber
authors: Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany.
authors: K
authors: K
authors: Kilk
authors: Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany.
authors: K
authors: K
authors: Listl
authors: Department of Hematology and Oncology, University of Heidelberg, Heidelberg, Germany.
authors: B
authors: B
authors: Wagner-Gund
authors: Department of Hematology and Oncology, University of Heidelberg, Heidelberg, Germany.
authors: M
authors: M
authors: Hillengass
authors: Department of Biostatistics, German Cancer Research Center, Heidelberg, Germany.
authors: T
authors: T
authors: Hielscher
authors: Department of Hematology and Oncology, University of Heidelberg, Heidelberg, Germany.
authors: A
authors: A
authors: Farid
authors: Department of Hematology and Oncology, University of Heidelberg, Heidelberg, Germany.
authors: K
authors: K
authors: Neben
authors: Department of Radiology, German Cancer Research Center, Heidelberg, Germany.
authors: S
authors: S
authors: Delorme
authors: Metabolism Branch, National Cancer Institute, Bethesda, MD, USA.
authors: O
authors: O
authors: Landgren
authors: 1] Department of Hematology and Oncology, University of Heidelberg, Heidelberg, Germany [2] National Center for Tumor Diseases, Heidelberg, Germany.
authors: H
authors: H
authors: Goldschmidt
mesh_terms: D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008998:Monoclonal Gammopathy of Undetermined Significance / Q000473:pathology*
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