» Articles » PMID: 23290477

Differentiation of Myeloma and Metastatic Cancer in the Spine Using Dynamic Contrast-enhanced MRI

Overview
Publisher Elsevier
Specialty Radiology
Date 2013 Jan 8
PMID 23290477
Citations 22
Authors
Affiliations
Soon will be listed here.
Abstract

Spinal myeloma and metastatic cancer cause similar symptoms and show similar imaging presentations, thus making them difficult to differentiate. In this study, dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) was performed to differentiate between 9 myelomas and 22 metastatic cancers that present as focal lesions in the spine. The characteristic DCE parameters, including the peak signal enhancement percentage (SE%), the steepest wash-in SE% during the ascending phase and the wash-out SE%, were calculated by normalizing to the precontrast signal intensity. The two-compartmental pharmacokinetic model was used to obtain K(trans) and kep. All nine myelomas showed the wash-out DCE pattern. Of the 22 metastatic cancers, 12 showed wash-out, 7 showed plateau, and 3 showed persistent enhancing patterns. The fraction of cases that showed the wash-out pattern was significantly higher in the myeloma group than the metastatic cancer group (9/9=100% vs. 12/22=55%, P=.03). Compared to the metastatic cancer group, the myeloma group had a higher peak SE% (226%±72% vs. 165%±60%, P=.044), a higher steepest wash-in SE% (169%±51% vs. 111%±41%, P=.01), a higher K(trans) (0.114±0.036 vs. 0.077±0.0281/min, P=.016) and a higher kep (0.88±0.26 vs. 0.49±0.23 1/min, P=.002). The receiver operating characteristic analysis to differentiate between these two groups showed that the area under the curve was 0.798 for K(trans), 0.864 for kep and 0.919 for combined K(trans) and kep. These results show that DCE-MRI may provide additional information for making differential diagnosis to aid in choosing the optimal subsequent procedures or treatments for spinal lesions.

Citing Articles

Radiomics model based on MRI to differentiate spinal multiple myeloma from metastases: A two-center study.

Cao J, Li Q, Zhang H, Wu Y, Wang X, Ding S J Bone Oncol. 2024; 45:100599.

PMID: 38601920 PMC: 11004638. DOI: 10.1016/j.jbo.2024.100599.


Multiple myeloma following bone metastasis of renal cell carcinoma: a case report.

Yu H, Zhang S, Feng X, Gao F Front Endocrinol (Lausanne). 2023; 14:1206368.

PMID: 38107521 PMC: 10722259. DOI: 10.3389/fendo.2023.1206368.


T1-Weighted, Dynamic Contrast-Enhanced MR Perfusion Imaging Can Differentiate between Treatment Success and Failure in Spine Metastases Undergoing Radiation Therapy.

Behar M, Peck K, Yildirim O, Tisnado J, Saha A, Arevalo-Perez J AJNR Am J Neuroradiol. 2023; 44(12):1451-1457.

PMID: 38049990 PMC: 10714859. DOI: 10.3174/ajnr.A8057.


Contrast-enhanced magnetic resonance image segmentation based on improved U-Net and Inception-ResNet in the diagnosis of spinal metastases.

Wang H, Xu S, Fang K, Dai Z, Wei G, Chen L J Bone Oncol. 2023; 42:100498.

PMID: 37670740 PMC: 10475503. DOI: 10.1016/j.jbo.2023.100498.


An MRI-based radiomics nomogram for differentiating spinal metastases from multiple myeloma.

Zhang S, Liu M, Li S, Cui J, Zhang G, Wang X Cancer Imaging. 2023; 23(1):72.

PMID: 37488622 PMC: 10367256. DOI: 10.1186/s40644-023-00585-4.


References
1.
Moehler T, Hawighorst H, Neben K, Egerer G, Hillengass J, Max R . Bone marrow microcirculation analysis in multiple myeloma by contrast-enhanced dynamic magnetic resonance imaging. Int J Cancer. 2001; 93(6):862-8. DOI: 10.1002/ijc.1421. View

2.
Kim H, Ryu K, Choi W, Choi B, Choi J, Yoon Y . Spinal involvement of hematopoietic malignancies and metastasis: differentiation using MR imaging. Clin Imaging. 1999; 23(2):125-33. DOI: 10.1016/s0899-7071(99)00105-9. View

3.
Baur A, Stabler A, Nagel D, Lamerz R, Bartl R, Hiller E . Magnetic resonance imaging as a supplement for the clinical staging system of Durie and Salmon?. Cancer. 2002; 95(6):1334-45. DOI: 10.1002/cncr.10818. View

4.
Baur A, Bartl R, Pellengahr C, Baltin V, Reiser M . Neovascularization of bone marrow in patients with diffuse multiple myeloma: a correlative study of magnetic resonance imaging and histopathologic findings. Cancer. 2004; 101(11):2599-604. DOI: 10.1002/cncr.20697. View

5.
Tofts P . Modeling tracer kinetics in dynamic Gd-DTPA MR imaging. J Magn Reson Imaging. 1997; 7(1):91-101. DOI: 10.1002/jmri.1880070113. View