European Radiology

, Volume 27, Issue 6, pp 2333–2347 | Cite as

Prognostic significance of focal lesions and diffuse infiltration on MRI for multiple myeloma: a meta-analysis

  • So-Yeon Lee
  • Hyun-Jung Kim
  • Yu Ri Shin
  • Hee-Jin Park
  • Yun-Gyoo Lee
  • Suk Joong Oh
Magnetic Resonance



MRI of bone marrow of the axial skeleton is recommended for evaluation of multiple myeloma. The impact of bone marrow involvement pattern on MRI for determining progression-free survival (PFS) and overall survival (OS) is not yet clear.


We performed a meta-analysis of research on the prognostic significance of MRI patterns for OS and PFS using a random effects model. Databases searched without language restriction were MEDLINE, EMBASE, and the Cochrane Library (January 1976 to April 2014). Manual searches were also conducted.


Of 10,953 citations identified in the original search, 10 cohort studies for a total of 2015 patients met the inclusion criteria. Nine of the 10 included studies are from three research groups. Pooled hazard ratios were 1.80 (95 % confidence interval [CI] 1.32–2.46; P < 0.001) for OS and 2.30 (95 % CI 1.65–3.20; P < 0.001) for PFS for focal lesions on MRI; and 1.70 (95 % CI 1.30–2.21; P < 0.001) for OS and 1.74 (95 % CI 1.07–2.85; P = 0.03) for PFS for diffuse infiltration on MRI. No significant heterogeneity was observed among studies.


This meta-analysis demonstrated an association between focal lesions and diffuse infiltration and poor prognosis in this population.

Key Points

MRI findings of multiple myeloma include normal, focal, variegated and diffuse infiltration

Focal lesions and diffuse infiltration on MRI were poor prognostic factors

Bone marrow involvement pattern on MRI can help physicians assess prognosis


Multiple myeloma MRI Prognosis Bone marrow Meta-analysis 



Hypercalcemia, renal failure, anemia and bone lesions


Computed tomography


Hazard ratio


International Myeloma Working Group


International staging system


Monoclonal gammopathy of undetermined significance


Magnetic resonance imaging


Overall survival


Progression-free survival


Quality in prognosis studies



The scientific guarantor of this publication is Hyun-Jung Kim. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. One of the authors has significant statistical expertise. Methodology: retrospective, performed at one institution.


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Copyright information

© European Society of Radiology 2016

Authors and Affiliations

  • So-Yeon Lee
    • 1
  • Hyun-Jung Kim
    • 2
  • Yu Ri Shin
    • 3
  • Hee-Jin Park
    • 1
  • Yun-Gyoo Lee
    • 4
  • Suk Joong Oh
    • 4
  1. 1.Department of Radiology, Kangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoulRepublic of Korea
  2. 2.Department of Preventive MedicineKorea University College of MedicineSeoulRepublic of Korea
  3. 3.Department of Radiology, Incheon St. Mary’s Hospital, College of MedicineThe Catholic University of KoreaSeoulRepublic of Korea
  4. 4.Division of Hematology and Oncology, Department of Internal Medicine, Kangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoulRepublic of Korea

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