Prognostic significance of focal lesions and diffuse infiltration on MRI for multiple myeloma: a meta-analysis
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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.
• 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
KeywordsMultiple myeloma MRI Prognosis Bone marrow Meta-analysis
Hypercalcemia, renal failure, anemia and bone lesions
International Myeloma Working Group
International staging system
Monoclonal gammopathy of undetermined significance
Magnetic resonance imaging
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.
- 10.Moulopoulos LA, Dimopoulos MA, Kastritis E et al (2012) Diffuse pattern of bone marrow involvement on magnetic resonance imaging is associated with high risk cytogenetics and poor outcome in newly diagnosed, symptomatic patients with multiple myeloma: a single center experience on 228 patients. Am J Hematol 87:861–864CrossRefPubMedGoogle Scholar
- 12.Song MK, Chung JS, Lee JJ et al (2014) Magnetic resonance imaging pattern of bone marrow involvement as a new predictive parameter of disease progression in newly diagnosed patients with multiple myeloma eligible for autologous stem cell transplantation. Br J Haematol 165:777–785CrossRefPubMedGoogle Scholar
- 19.Stabler A, Baur A, Bartl R, Munker R, Lamerz R, Reiser MF (1996) Contrast enhancement and quantitative signal analysis in MR imaging of multiple myeloma: assessment of focal and diffuse growth patterns in marrow correlated with biopsies and survival rates. AJR Am J Roentgenol 167:1029–1036CrossRefPubMedGoogle Scholar
- 20.Green S (2011) Cochrane handbook for systematic reviews of interventions version 5.1. 0 [updated March 2011]. The Cochrane CollaborationGoogle Scholar