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Publications (2)10.68 Total impact

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    ABSTRACT: To evaluate the effectiveness of the iterative decomposition of water and fat with echo asymmetric and least-squares estimation (IDEAL) MRI to quantify tumour infiltration into the lumbar vertebrae in myeloma patients without visible focal lesions. The lumbar spine was examined with 3 T MRI in 24 patients with multiple myeloma and in 26 controls. The fat-signal fraction was calculated as the mean value from three vertebral bodies. A post hoc test was used to compare the fat-signal fraction in controls and patients with monoclonal gammopathy of undetermined significance (MGUS), asymptomatic myeloma or symptomatic myeloma. Differences were considered significant at P < 0.05. The fat-signal fraction and β(2)-microglobulin-to-albumin ratio were entered into the discriminant analysis. Fat-signal fractions were significantly lower in patients with symptomatic myelomas (43.9 ±19.7%, P < 0.01) than in the other three groups. Discriminant analysis showed that 22 of the 24 patients (92%) were correctly classified into symptomatic or non-symptomatic myeloma groups. Fat quantification using the IDEAL sequence in MRI was significantly different when comparing patients with symptomatic myeloma and those with asymptomatic myeloma. The fat-signal fraction and β(2)-microglobulin-to-albumin ratio facilitated discrimination of symptomatic myeloma from non-symptomatic myeloma in patients without focal bone lesions. KEY POINTS : • A new magnetic resonance technique (IDEAL) offers new insights in multiple myeloma. • Fat-signal fractions were lower in patients with symptomatic myelomas than in those with asymptomatic myelomas. • The β2-microglobulin-to-albumin ratio also aided discrimination of symptomatic myeloma. • The fat-signal fraction may provide information about the myeloma cell mass.
    European Radiology 12/2011; 22(5):1114-21. · 4.34 Impact Factor
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    ABSTRACT: To evaluate the accuracy of trabecular analysis of the lumbar spine by using multidetector computed tomography (CT) in differentiating multiple myeloma patients without spinal fractures from control subjects. This retrospective single-institution study was approved by the institutional review board, with a waiver of informed consent. Spinal microarchitecture was examined by using 64-detector row CT in 29 patients with multiple myeloma and 51 control subjects. The patients were 13 men and 16 women (mean ages, 71.1 and 69.2 years, respectively). By using multidetector CT data, eight parameters were calculated for the L3 vertebral trabeculae with a three-dimensional image analysis system. The χ(2) test was used to select a preliminary set of predictors for multiple myeloma. A multivariable generalized linear model was constructed to identify parameters that could be used to differentiate between patients and controls. Parameters with findings of P < .05 were included in the multivariable model. Generalized linear models showed that mean trabecular thickness (TbTh) (patients, 703.7 μm ± 46.7 [standard deviation]; controls, 661.1 μm ± 35.7) and fractal dimension (FD) (patients, 2.23 ± 0.24; controls, 2.41 ± 0.15) in men (P = .05 and .03, respectively) and degree of anisotropy (DA) (patients, 1.63 ± 0.23; controls, 1.38 ± 0.10) in women (P = .02) had significant effects in differentiation between patients and controls. Significant differences were observed in spinal microarchitecture between control subjects and multiple myeloma patients without pathologic fractures. Independent predictors of multiple myeloma included TbTh and FD in male patients and DA in female patients.
    Radiology 04/2011; 260(2):472-9. · 6.34 Impact Factor