Structured whole-body MRI highlights clinically relevant disease pattern changes in relapsed/refractory multiple...

Area of Science:

• Oncology
• Radiology
• Hematology

Background:

• Whole-body imaging is crucial for multiple myeloma (MM) assessment.
• MY-RADS and KIM scores are established for newly diagnosed MM (NDMM).
• Prognostic utility of these scores in relapsed/refractory MM (RRMM) is unclear.

Purpose of the Study:

• To evaluate the application and prognostic significance of MY-RADS and KIM scores in RRMM.
• To compare imaging findings between RRMM and NDMM patients.

Main Methods:

• Whole-body MRI data from 46 RRMM patients were analyzed.
• Findings were compared to 68 NDMM patients from the GMMG-HD7 trial.
• MY-RADS and KIM scoring systems were applied to both cohorts.

Main Results:

• RRMM patients exhibited increased paramedullary/extramedullary disease and less diffuse marrow infiltration than NDMM.
• Despite similar overall disease burden, distinct imaging patterns were observed.
• Both MY-RADS and KIM scores independently correlated with progression-free and overall survival in RRMM.

Conclusions:

• RRMM shows distinct biological patterns, with a shift towards bone marrow-independent growth.
• Whole-body MRI scoring systems (MY-RADS, KIM) are prognostically significant in RRMM.
• Imaging may better capture disease burden than iliac crest biopsies in RRMM.