Multiple Myeloma (MM) is the second most common hematologic malignancy in the United States. MM originates in the bone marrow and eventually creates bone lesions, occurring in ~60% of patients at diagnosis, and in all patients over the course of the disease. It results in severe bone pain, hypercalcemia, and spinal cord compression leading to pathologic fractures or paralysis. Whole-body X-ray is currently used to identify bone lesions, however, they are most often detected only at advanced stages. The International Myeloma Working Group (IMWG) now recommends whole-body magnetic resonance imaging (WBMRI) as the preferred imaging technique for pretreatment assessment. However, MRI is most of...
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Multiple Myeloma (MM) is the second most common hematologic malignancy in the United States. MM originates in the bone marrow and eventually creates bone lesions, occurring in ~60% of patients at diagnosis, and in all patients over the course of the disease. It results in severe bone pain, hypercalcemia, and spinal cord compression leading to pathologic fractures or paralysis. Whole-body X-ray is currently used to identify bone lesions, however, they are most often detected only at advanced stages. The International Myeloma Working Group (IMWG) now recommends whole-body magnetic resonance imaging (WBMRI) as the preferred imaging technique for pretreatment assessment. However, MRI is most often limited to evaluation of the spine and pelvic regions in clinical practice to minimize costs associated with prolonged acquisition times and to improve patient comfort. This increases the potential for missing lesions outside these anatomic locations. To address these shortcomings, we have developed a novel WBMRI technique called, DETECT (Wang X et. al. Magn Reson Med. 2018, PMID: 29446127), that shows improved lesion detection (~40% more lesions) in ~60% shorter scan times (7 min vs. 22 min), compared to the currently used WBMRI with diffusion-weighted imaging (DWI). DETECT also provides signal in the bone marrow that can be used to measure response to therapy. In this clinical translational research project, we will evaluate this novel WBMRI technique along with contrast-enhanced MRI for lesion detection and therapy response assessment in MM in <30 minutes of total scan time. If successful, this will establish a personalized profile of lesion detection and longitudinal evaluation of therapy response in MM patients without exposure to ionizing radiation or nephrotoxic iodinated contrast agent. This provides pertinent clinical information that leads to better management of MM patients and subsequently, improved quality of life and overall survival.
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