Treatment response assessment using whole body diffusion weighted-magnetic resonance imaging in myeloma: a retrospective cohort study

Le résumé fourni par la source

This bi-institutional retrospective cohort study evaluated whole-body diffusion-weighted MRI (WB DW-MRI) for myeloma response assessment and its concordance with bone marrow minimal residual disease (MRD) testing. Among 53 patients, 49.1% achieved imaging complete response (imaging-CR; defined as no active focal lesions or diffuse infiltration) on post-treatment WB DW-MRI, while 33.96% showed multiple active focal lesions, 7.5% had a single active lesion, and 5.7% demonstrated persistent diffuse infiltration. Patients achieving imaging-CR demonstrated superior progression-free survival compared to non-CR patients (median not reached vs 43.3 months respectively; p = 0.025). Notably, only slight concordance was observed between bone marrow MRD (at 10–5 sensitivity) and imaging (Cohen’s kappa coefficient = 0.197). Importantly, 38.5% of MRD-negative patients with persistent imaging abnormalities progressed during follow-up, whereas PET/CT-based CR showed no prognostic impact. This study establishes WB DW-MRI as a feasible response assessment tool in myeloma with significant prognostic value in the context of modern therapies.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.