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Lack of Spleen Signal on Diffusion Weighted MRI is associated with High Tumor Burden and Poor Prognosis in Multiple Myeloma: A Link to Extramedullary Hematopoiesis?
Due to the low frequency of abnormalities affecting the spleen, this organ is often overlooked during radiological examinations. Here, we report on the unexpected finding, that the spleen signal on diffusion-weighted MRI (DW-MRI) is associated with clinical parameters in patients with plasma cell dy...
Autores principales: | , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Ivyspring International Publisher
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6643447/ https://www.ncbi.nlm.nih.gov/pubmed/31367255 http://dx.doi.org/10.7150/thno.33289 |
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author | Rasche, Leo Kumar, Manoj Gershner, Grant Samant, Rohan Van Hemert, Rudy Heidemeier, Anke Lapa, Constantin Bley, Thorsten Buck, Andreas McDonald, James Hillengass, Jens Epstein, Joshua Thanendrarajan, Sharmilan Schinke, Carolina van Rhee, Frits Zangari, Maurizio Barlogie, Bart Davies, Faith E Morgan, Gareth J Weinhold, Niels |
author_facet | Rasche, Leo Kumar, Manoj Gershner, Grant Samant, Rohan Van Hemert, Rudy Heidemeier, Anke Lapa, Constantin Bley, Thorsten Buck, Andreas McDonald, James Hillengass, Jens Epstein, Joshua Thanendrarajan, Sharmilan Schinke, Carolina van Rhee, Frits Zangari, Maurizio Barlogie, Bart Davies, Faith E Morgan, Gareth J Weinhold, Niels |
author_sort | Rasche, Leo |
collection | PubMed |
description | Due to the low frequency of abnormalities affecting the spleen, this organ is often overlooked during radiological examinations. Here, we report on the unexpected finding, that the spleen signal on diffusion-weighted MRI (DW-MRI) is associated with clinical parameters in patients with plasma cell dyscrasias. Methods: We investigated the spleen signal on DW-MRI together with clinical and molecular parameters in 295 transplant-eligible newly diagnosed Multiple Myeloma (NDMM) patients and in 72 cases with monoclonal gammopathy of undetermined significance (MGUS). Results: Usually, the spleen is the abdominal organ with the highest intensities on DW-MRI. Yet, significant signal loss on DW-MRI images was seen in 71 of 295 (24%) NDMM patients. This phenomenon was associated with the level of bone marrow plasmacytosis (P=1x10(-10)) and International Staging System 3 (P=0.0001) but not with gain(1q), and del(17p) or plasma cell gene signatures. The signal was preserved in 72 individuals with monoclonal gammopathy of undetermined significance and generally re-appeared in MM patients responding to treatment, suggesting that lack of signal reflects increased tumor burden. While absence of spleen signal in MM patients with high risk disease defined a subgroup with very poor outcome, re-appearance of the spleen signal after autologous stem cell transplantation was seen in patients with improved outcome. Our preliminary observation suggests that extramedullary hematopoiesis in the spleen is a factor that modifies the DW-MRI signal of this organ. Conclusions: The DW-MRI spleen signal is a promising marker for tumor load and provides prognostic information in MM. |
format | Online Article Text |
id | pubmed-6643447 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Ivyspring International Publisher |
record_format | MEDLINE/PubMed |
spelling | pubmed-66434472019-07-31 Lack of Spleen Signal on Diffusion Weighted MRI is associated with High Tumor Burden and Poor Prognosis in Multiple Myeloma: A Link to Extramedullary Hematopoiesis? Rasche, Leo Kumar, Manoj Gershner, Grant Samant, Rohan Van Hemert, Rudy Heidemeier, Anke Lapa, Constantin Bley, Thorsten Buck, Andreas McDonald, James Hillengass, Jens Epstein, Joshua Thanendrarajan, Sharmilan Schinke, Carolina van Rhee, Frits Zangari, Maurizio Barlogie, Bart Davies, Faith E Morgan, Gareth J Weinhold, Niels Theranostics Research Paper Due to the low frequency of abnormalities affecting the spleen, this organ is often overlooked during radiological examinations. Here, we report on the unexpected finding, that the spleen signal on diffusion-weighted MRI (DW-MRI) is associated with clinical parameters in patients with plasma cell dyscrasias. Methods: We investigated the spleen signal on DW-MRI together with clinical and molecular parameters in 295 transplant-eligible newly diagnosed Multiple Myeloma (NDMM) patients and in 72 cases with monoclonal gammopathy of undetermined significance (MGUS). Results: Usually, the spleen is the abdominal organ with the highest intensities on DW-MRI. Yet, significant signal loss on DW-MRI images was seen in 71 of 295 (24%) NDMM patients. This phenomenon was associated with the level of bone marrow plasmacytosis (P=1x10(-10)) and International Staging System 3 (P=0.0001) but not with gain(1q), and del(17p) or plasma cell gene signatures. The signal was preserved in 72 individuals with monoclonal gammopathy of undetermined significance and generally re-appeared in MM patients responding to treatment, suggesting that lack of signal reflects increased tumor burden. While absence of spleen signal in MM patients with high risk disease defined a subgroup with very poor outcome, re-appearance of the spleen signal after autologous stem cell transplantation was seen in patients with improved outcome. Our preliminary observation suggests that extramedullary hematopoiesis in the spleen is a factor that modifies the DW-MRI signal of this organ. Conclusions: The DW-MRI spleen signal is a promising marker for tumor load and provides prognostic information in MM. Ivyspring International Publisher 2019-07-09 /pmc/articles/PMC6643447/ /pubmed/31367255 http://dx.doi.org/10.7150/thno.33289 Text en © The author(s) This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/). See http://ivyspring.com/terms for full terms and conditions. |
spellingShingle | Research Paper Rasche, Leo Kumar, Manoj Gershner, Grant Samant, Rohan Van Hemert, Rudy Heidemeier, Anke Lapa, Constantin Bley, Thorsten Buck, Andreas McDonald, James Hillengass, Jens Epstein, Joshua Thanendrarajan, Sharmilan Schinke, Carolina van Rhee, Frits Zangari, Maurizio Barlogie, Bart Davies, Faith E Morgan, Gareth J Weinhold, Niels Lack of Spleen Signal on Diffusion Weighted MRI is associated with High Tumor Burden and Poor Prognosis in Multiple Myeloma: A Link to Extramedullary Hematopoiesis? |
title | Lack of Spleen Signal on Diffusion Weighted MRI is associated with High Tumor Burden and Poor Prognosis in Multiple Myeloma: A Link to Extramedullary Hematopoiesis? |
title_full | Lack of Spleen Signal on Diffusion Weighted MRI is associated with High Tumor Burden and Poor Prognosis in Multiple Myeloma: A Link to Extramedullary Hematopoiesis? |
title_fullStr | Lack of Spleen Signal on Diffusion Weighted MRI is associated with High Tumor Burden and Poor Prognosis in Multiple Myeloma: A Link to Extramedullary Hematopoiesis? |
title_full_unstemmed | Lack of Spleen Signal on Diffusion Weighted MRI is associated with High Tumor Burden and Poor Prognosis in Multiple Myeloma: A Link to Extramedullary Hematopoiesis? |
title_short | Lack of Spleen Signal on Diffusion Weighted MRI is associated with High Tumor Burden and Poor Prognosis in Multiple Myeloma: A Link to Extramedullary Hematopoiesis? |
title_sort | lack of spleen signal on diffusion weighted mri is associated with high tumor burden and poor prognosis in multiple myeloma: a link to extramedullary hematopoiesis? |
topic | Research Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6643447/ https://www.ncbi.nlm.nih.gov/pubmed/31367255 http://dx.doi.org/10.7150/thno.33289 |
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