title: Combined evaluation of conventional MRI, dynamic contrast-enhanced MRI and diffusion weighted imaging for response evaluation of patients with multiple myeloma.
abstract: OBJECTIVE
  To evaluate the value of the combined evaluation of SE MRI, dynamic contrast enhanced MRI (DCE-MRI) and diffusion weighted imaging (DWI) in multiple myeloma (MM) patients after treatment compared to the international myeloma working group (IMWG) response criteria.
  
  
  METHODS
  The retrospective study includes 27 newly diagnosed patients, providing 99 MRI-investigations. Patients were categorized according to the IMWG response criteria. Quantitative assessment was based on signal intensities (SI) of T1-weighted, fat-saturated T2-weighted and b1000 images, apparent diffusion coefficients (ADC) and parameters from time-intensity-curves (TIC) derived from L3. Qualitative visual analysis of conventional MRI-images, b1000-images and TICs, providing a "combined skeletal score", was used to create MRI response criteria.
  
  
  RESULTS
  The combined skeletal score could significantly differentiate between subgroups based on IMWG response criteria (p=0.016). The gold standard plasmacytosis could significantly differentiate between subgroups based on MRI response criteria (p<0.001), as well as slope (p<0.001) and ADC (p=0.006). There is a good agreement between IMWG and MRI response criteria (Kendall's coefficient=0.761).
  
  
  CONCLUSIONS
  Response evaluation of MM-patients based on the combination of anatomical information from conventional MRI with functional information from DCE-MRI and DWI, is useful for monitoring therapy.
authors.affiliation: Ghent University, Department of Radiology, MR -1K12, Ghent University Hospital, De Pintelaan 185, B-9000 Gent, Belgium. Electronic address: Julie.Dutoit@UGent.be.
authors.forename: Julie C
authors.initials: JC
authors.lastname: Dutoit
authors.affiliation: Ghent University, Department of Radiology, MR -1K12, Ghent University Hospital, De Pintelaan 185, B-9000 Gent, Belgium. Electronic address: Eveline.Claus@UGent.be.
authors.forename: Eveline
authors.initials: E
authors.lastname: Claus
authors.affiliation: Heamatologist, Ghent University, Department of Haematology, 7K12, Ghent University Hospital, De Pintelaan 185 B-9000 Gent, Belgium. Electronic address: Fritz.Offner@UGent.be.
authors.forename: Fritz
authors.initials: F
authors.lastname: Offner
authors.affiliation: Heamatologist, Ghent University, Department of Haematology, 7K12, Ghent University Hospital, De Pintelaan 185 B-9000 Gent, Belgium. Electronic address: Lucien.Noens@UGent.be.
authors.forename: Lucien
authors.initials: L
authors.lastname: Noens
authors.affiliation: Heamatologist, Ghent University, Department of Clinical Chemistry, P8, Ghent University Hospital, De Pintelaan 185, B-9000 Gent, Belgium. Electronic address: Joris.Delanghe@UGent.be.
authors.forename: Joris
authors.initials: J
authors.lastname: Delanghe
authors.affiliation: Ghent University, Department of Radiology, MR -1K12, Ghent University Hospital, De Pintelaan 185, B-9000 Gent, Belgium. Electronic address: Koenraad.Verstraete@UGent.be.
authors.forename: Koenraad L
authors.initials: KL
authors.lastname: Verstraete
mesh_terms: D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D005260:Female; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009101:Multiple Myeloma / Q000473:pathology* / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media
keywords: Diffusion weighted imaging; Dynamic contrast enhanced MRI; Multiple myeloma; Response assessment