title: Predictive value of longitudinal whole-body magnetic resonance imaging in patients with smoldering multiple myeloma.
abstract: Previous studies demonstrated the relevance of focal lesions (FL) in whole-body magnetic resonance imaging (wb-MRI) at the initial workup of patients with smoldering multiple myeloma (SMM). The aim of this study was to assess the effects of longitudinal wb-MRIs on progression into multiple myeloma (MM). Sixty-three patients with SMM were analyzed who received at least two wb-MRIs for follow-up before progression into MM. Radiological progressive disease (MRI-PD) was defined as detection of new FL or increase in diameter of existing FL and a novel or progressive diffuse infiltration. Radiological stable disease (MRI-SD) was defined by no change compared with the prior MRI. Patients were followed-up every 3-6 months, including a serological and clinical evaluation. One Hundred and eighty-two wb-MRIs were analyzed. MRI-PD occurred in 31 patients (49%), and 25 (40%) patients developed MM. MRI-PD was highly significantly associated with progression into MM, regardless of findings at the initial MRI. In multivariate analysis, MRI-PD remained a risk factor, independent of relevant baseline parameters like serum monoclonal protein or ⩾95% aberrant plasma cells in the bone marrow. Patients with MRI-SD had no higher risk of progression, even when FL were present at the initial MRI. Therefore, MRI is suitable for the follow-up of patients with SMM.
authors.affiliation: 1] Department of Hematology and Oncology, University Hospital of Heidelberg, Heidelberg, Germany [2] Department of Radiology, German Cancer Research Center, Heidelberg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Merz
authors.affiliation: Division of Biostatistics, German Cancer Research Center, Heidelberg, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Hielscher
authors.affiliation: Department of Radiology, German Cancer Research Center, Heidelberg, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Wagner
authors.affiliation: Department of Hematology and Oncology, University Hospital of Heidelberg, Heidelberg, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Sauer
authors.affiliation: Department of Hematology and Oncology, University Hospital of Heidelberg, Heidelberg, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Shah
authors.affiliation: Department of Hematology and Oncology, University Hospital of Heidelberg, Heidelberg, Germany.
authors.forename: M S
authors.initials: MS
authors.lastname: Raab
authors.affiliation: Department of Human Genetics, University Hospital of Heidelberg, Heidelberg, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Jauch
authors.affiliation: Department of Hematology and Oncology, University Hospital of Heidelberg, Heidelberg, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Neben
authors.affiliation: Department of Hematology and Oncology, University Hospital of Heidelberg, Heidelberg, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Hose
authors.affiliation: Department of Hematology and Oncology, University Hospital of Heidelberg, Heidelberg, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Egerer
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.
authors.forename: M A
authors.initials: MA
authors.lastname: Weber
authors.affiliation: Department of Radiology, German Cancer Research Center, Heidelberg, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Delorme
authors.affiliation: 1] Department of Hematology and Oncology, University Hospital of Heidelberg, Heidelberg, Germany [2] National Center for Tumor Diseases, Heidelberg, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Goldschmidt
authors.affiliation: 1] Department of Hematology and Oncology, University Hospital of Heidelberg, Heidelberg, Germany [2] Department of Radiology, German Cancer Research Center, Heidelberg, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Hillengass
mesh_terms: D000328:Adult; D000368:Aged; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D009101:Multiple Myeloma / Q000473:pathology*; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012189:Retrospective Studies