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Koenraad Verstraete - One of the best experts on this subject based on the ideXlab platform.
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MRI in multiple Myeloma : a pictorial review of diagnostic and post-treatment findings
Insights into imaging, 2016Co-Authors: Julie C. Dutoit, Koenraad VerstraeteAbstract:Magnetic resonance imaging (MRI) is increasingly being used in the diagnostic work-up of patients with multiple Myeloma. Since 2014, MRI findings are included in the new diagnostic criteria proposed by the International Myeloma Working Group. Patients with Smouldering Myeloma presenting with more than one unequivocal focal lesion in the bone marrow on MRI are considered having symptomatic Myeloma requiring treatment, regardless of the presence of lytic bone lesions. However, bone marrow evaluation with MRI offers more than only morphological information regarding the detection of focal lesions in patients with MM. The overall performance of MRI is enhanced by applying dynamic contrast-enhanced MRI and diffusion weighted imaging sequences, providing additional functional information on bone marrow vascularization and cellularity.This pictorial review provides an overview of the most important imaging findings in patients with monoclonal gammopathy of undetermined significance, Smouldering Myeloma and multiple Myeloma, by performing a 'total' MRI investigation with implications for the diagnosis, staging and response assessment. Main message • Conventional MRI diagnoses multiple Myeloma by assessing the infiltration pattern. • Dynamic contrast-enhanced MRI diagnoses multiple Myeloma by assessing vascularization and perfusion. • Diffusion weighted imaging evaluates bone marrow composition and cellularity in multiple Myeloma. • Combined morphological and functional MRI provides optimal bone marrow assessment for staging. • Combined morphological and functional MRI is of considerable value in treatment follow-up.
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The diagnostic value of SE MRI and DWI of the spine in patients with monoclonal gammopathy of undetermined significance, Smouldering Myeloma and multiple Myeloma.
European radiology, 2014Co-Authors: Julie C. Dutoit, Matthias A. Vanderkerken, Joris Anthonissen, Frederick Dochy, Koenraad VerstraeteAbstract:To evaluate DWI of the bone marrow in the differentiation of monoclonal gammopathy of undetermined significance (MGUS), Smouldering Myeloma (SMM) and multiple Myeloma (MM). The retrospective study includes 64 patients with MGUS, 27 with SMM, 64 with new MM and 12 controls. Signal intensity (SI) of spinal SE-MRI and DWI (b0-1000) as well as apparent diffusion coefficients (ADC) were measured in the T10 and L3. Qualitative assessment of b-images was performed by one experienced radiologist. ADC600 and ADC1000 are the best ADC values in differentiating patient groups (p 50 % (p = 0.001). Only SIT2 for L3 can differentiate MGUS from SMM (p = 0.044) and PC%0-10 from PC%10-25 (p = 0.033). Qualitative interpretation of b1000 images allows differentiating MM patients from those with MGUS or SMM (p
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the diagnostic value of se mri and dwi of the spine in patients with monoclonal gammopathy of undetermined significance Smouldering Myeloma and multiple Myeloma
European Radiology, 2014Co-Authors: Julie C. Dutoit, Matthias A. Vanderkerken, Joris Anthonissen, Frederick Dochy, Koenraad VerstraeteAbstract:To evaluate DWI of the bone marrow in the differentiation of monoclonal gammopathy of undetermined significance (MGUS), Smouldering Myeloma (SMM) and multiple Myeloma (MM). The retrospective study includes 64 patients with MGUS, 27 with SMM, 64 with new MM and 12 controls. Signal intensity (SI) of spinal SE-MRI and DWI (b0-1000) as well as apparent diffusion coefficients (ADC) were measured in the T10 and L3. Qualitative assessment of b-images was performed by one experienced radiologist. ADC600 and ADC1000 are the best ADC values in differentiating patient groups (p 50 % (p = 0.001). Only SIT2 for L3 can differentiate MGUS from SMM (p = 0.044) and PC%0-10 from PC%10-25 (p = 0.033). Qualitative interpretation of b1000 images allows differentiating MM patients from those with MGUS or SMM (p < 0.001). Spinal SE-MRI can differentiate among MGUS, SMM, MM and control subjects. DWI based on the SI on b1000 images and ADC values is increased in MM compared to MGUS and SMM. Qualitative assessment of b-images can differentiate MM from MGUS or SMM. • ADC values are higher in patients with MM compared to MGUS • DWI parameters change late in disease evolution • DWI is sensitive but not specific in diagnosing patients with MM • Qualitative DWI assessment is good in detecting Myeloma patients
Julie C. Dutoit - One of the best experts on this subject based on the ideXlab platform.
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MRI in multiple Myeloma : a pictorial review of diagnostic and post-treatment findings
Insights into imaging, 2016Co-Authors: Julie C. Dutoit, Koenraad VerstraeteAbstract:Magnetic resonance imaging (MRI) is increasingly being used in the diagnostic work-up of patients with multiple Myeloma. Since 2014, MRI findings are included in the new diagnostic criteria proposed by the International Myeloma Working Group. Patients with Smouldering Myeloma presenting with more than one unequivocal focal lesion in the bone marrow on MRI are considered having symptomatic Myeloma requiring treatment, regardless of the presence of lytic bone lesions. However, bone marrow evaluation with MRI offers more than only morphological information regarding the detection of focal lesions in patients with MM. The overall performance of MRI is enhanced by applying dynamic contrast-enhanced MRI and diffusion weighted imaging sequences, providing additional functional information on bone marrow vascularization and cellularity.This pictorial review provides an overview of the most important imaging findings in patients with monoclonal gammopathy of undetermined significance, Smouldering Myeloma and multiple Myeloma, by performing a 'total' MRI investigation with implications for the diagnosis, staging and response assessment. Main message • Conventional MRI diagnoses multiple Myeloma by assessing the infiltration pattern. • Dynamic contrast-enhanced MRI diagnoses multiple Myeloma by assessing vascularization and perfusion. • Diffusion weighted imaging evaluates bone marrow composition and cellularity in multiple Myeloma. • Combined morphological and functional MRI provides optimal bone marrow assessment for staging. • Combined morphological and functional MRI is of considerable value in treatment follow-up.
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The diagnostic value of SE MRI and DWI of the spine in patients with monoclonal gammopathy of undetermined significance, Smouldering Myeloma and multiple Myeloma
European Radiology, 2014Co-Authors: Julie C. Dutoit, Matthias A. Vanderkerken, Joris Anthonissen, Frederick Dochy, Koenraad L. VerstraeteAbstract:Objectives To evaluate DWI of the bone marrow in the differentiation of monoclonal gammopathy of undetermined significance (MGUS), Smouldering Myeloma (SMM) and multiple Myeloma (MM). Methods The retrospective study includes 64 patients with MGUS, 27 with SMM, 64 with new MM and 12 controls. Signal intensity (SI) of spinal SE-MRI and DWI (b0-1000) as well as apparent diffusion coefficients (ADC) were measured in the T10 and L3. Qualitative assessment of b-images was performed by one experienced radiologist. Results ADC600 and ADC1000 are the best ADC values in differentiating patient groups ( p
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The diagnostic value of SE MRI and DWI of the spine in patients with monoclonal gammopathy of undetermined significance, Smouldering Myeloma and multiple Myeloma.
European radiology, 2014Co-Authors: Julie C. Dutoit, Matthias A. Vanderkerken, Joris Anthonissen, Frederick Dochy, Koenraad VerstraeteAbstract:To evaluate DWI of the bone marrow in the differentiation of monoclonal gammopathy of undetermined significance (MGUS), Smouldering Myeloma (SMM) and multiple Myeloma (MM). The retrospective study includes 64 patients with MGUS, 27 with SMM, 64 with new MM and 12 controls. Signal intensity (SI) of spinal SE-MRI and DWI (b0-1000) as well as apparent diffusion coefficients (ADC) were measured in the T10 and L3. Qualitative assessment of b-images was performed by one experienced radiologist. ADC600 and ADC1000 are the best ADC values in differentiating patient groups (p 50 % (p = 0.001). Only SIT2 for L3 can differentiate MGUS from SMM (p = 0.044) and PC%0-10 from PC%10-25 (p = 0.033). Qualitative interpretation of b1000 images allows differentiating MM patients from those with MGUS or SMM (p
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the diagnostic value of se mri and dwi of the spine in patients with monoclonal gammopathy of undetermined significance Smouldering Myeloma and multiple Myeloma
European Radiology, 2014Co-Authors: Julie C. Dutoit, Matthias A. Vanderkerken, Joris Anthonissen, Frederick Dochy, Koenraad VerstraeteAbstract:To evaluate DWI of the bone marrow in the differentiation of monoclonal gammopathy of undetermined significance (MGUS), Smouldering Myeloma (SMM) and multiple Myeloma (MM). The retrospective study includes 64 patients with MGUS, 27 with SMM, 64 with new MM and 12 controls. Signal intensity (SI) of spinal SE-MRI and DWI (b0-1000) as well as apparent diffusion coefficients (ADC) were measured in the T10 and L3. Qualitative assessment of b-images was performed by one experienced radiologist. ADC600 and ADC1000 are the best ADC values in differentiating patient groups (p 50 % (p = 0.001). Only SIT2 for L3 can differentiate MGUS from SMM (p = 0.044) and PC%0-10 from PC%10-25 (p = 0.033). Qualitative interpretation of b1000 images allows differentiating MM patients from those with MGUS or SMM (p < 0.001). Spinal SE-MRI can differentiate among MGUS, SMM, MM and control subjects. DWI based on the SI on b1000 images and ADC values is increased in MM compared to MGUS and SMM. Qualitative assessment of b-images can differentiate MM from MGUS or SMM. • ADC values are higher in patients with MM compared to MGUS • DWI parameters change late in disease evolution • DWI is sensitive but not specific in diagnosing patients with MM • Qualitative DWI assessment is good in detecting Myeloma patients
Mary R. Cahill - One of the best experts on this subject based on the ideXlab platform.
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Platelet hyperactivation in multiple Myeloma is also evident in patients with premalignant monoclonal gammopathy of undetermined significance.
British journal of haematology, 2020Co-Authors: Leanne Rose O'sullivan, Gerardene Meade-murphy, Oonagh Gilligan, Vitaliy Mykytiv, Paul Young, Mary R. CahillAbstract:Thrombotic events are common in patients with multiple Myeloma (MM), Smouldering Myeloma (SM) and monoclonal gammopathy of undetermined significance (MGUS). Previous studies have indicated platelet hyperactivation as a feature of thrombotic risk in MM, but there is a dearth of data in MGUS. In the present study, multiparameter analysis of platelet activation and responsiveness was investigated by flow cytometry in patients with MGUS, SM/MM and healthy controls (HCs). The median platelet surface CD63 levels, annexin V and PAC-1 antibody (specific for activated integrin αIIbβ3) binding were significantly elevated in patients with MGUS versus the HCs. These markers were also elevated in SM/MM, but not significantly. In all, 74% of MGUS and 38% of SM/MM patients had one or more elevated marker of platelet activation, compared to 19% of the HCs. Marker-specific hyporesponsiveness of platelets to agonist [adenosine diphosphate (ADP), thrombin receptor-activating peptide 6] stimulation in vitro was observed, with significantly reduced surface levels of P-selectin in response to ADP in patients with MGUS. Platelet-leucocyte aggregates were not altered in patients, while platelet-associated immunoglobulins were elevated in a subset of patients. Overall, we found that platelet hyperactivation is prevalent in both MGUS and SM/MM patients and is potentially related to hyporesponsiveness. These observations suggest that further investigation of the predictive and prognostic value of platelet hyperactivation in such patients is warranted.
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MM-080: Platelet Hyperactivation in Multiple Myeloma Is Also Evident in Premalignant MGUS Patients and Persists During Treatment Initiation
Clinical Lymphoma Myeloma and Leukemia, 2020Co-Authors: Leanne Rose O'sullivan, Gerardene Meade-murphy, Oonagh Gilligan, Vitaliy Mykytiv, Paul Young, Mary R. CahillAbstract:Context: Thrombotic events are a common complication in multiple Myeloma (MM) and Smouldering Myeloma (SM) patients, and are increasingly being recognized as a feature of MGUS. Platelet hyperactivation has been implicated in this prothrombotic state but remains to be characterized in MGUS patients and MM patients initiating treatment, when thrombotic risk is greatest. Objective: To address this, we evaluated platelet activation status with an extended panel of platelet activation markers (PAC-1, P-selectin, CD63, Annexin V) and platelet responsiveness to agonists (ADP, TRAP-6) in patients and healthy controls (HC). We also assessed additional parameters; reticulated platelet levels, platelet-leucocyte aggregates (PLA), and platelet-associated immunoglobulins (PAIg). Design, Setting & Patients: MGUS (n=19) and SM (n=4) patients who lacked anticoagulant use and underlying bleeding, thrombotic, and renal disorders were recruited from outpatient clinics. Newly diagnosed MM (n=12) patients were recruited using same criteria. A subset of MM patients (n=8) provided samples two months post-initiating treatment. HC (n=16) underwent paraprotein screening to exclude MGUS status. Interventions: No interventions to routine care. MM patients received Bortezomib (Velcade), dexamethasone and Lenalidomide (Revlimid) (VRD) (n=4) or cyclophosphamide (VCD) (n=4), and aspirin thromboprophylaxis (n=5). Main outcome measures: Platelets are hyperactivated and hyporesponsive to agonists in MGUS and SM/MM patients at diagnosis and in patients undergoing treatment. Results: Median platelet activation marker levels were elevated in patients versus HC, significantly for MGUS in terms of PAC-1 (0.72 v 1.7%, p=0.024), CD63 (0.55 v 1.29%, p=0.003), Annexin V (0.47 v 1.61%, p=0.004). In MM undergoing treatment, P-selectin (1.00 v 2.46%, p=0.010), CD63 (0.48 v 1.32%, p=0.020) and Annexin V (0.54 v 1.51%, p=0.038) were significantly elevated versus HC at diagnosis and remained elevated after treatment. MGUS patients had significantly reduced P-selectin levels in response to ADP (34.85 v 10.77%, p=0.005). In MM, hyporesponsiveness was evident versus HC at diagnosis and following treatment in terms of PAC-1 (58.5 v 34.91%, p=0.009) and P-selectin (42.21 v 23.49%, p=0.028). PLA (2.38 v 5.84%, p=0.023) and reticulated platelet levels (1.82 v 24.5%, p=0.031) increased significantly in MM after treatment. PAIg were evident in subsets of MGUS and SM/MM patients. Conclusions: This study reports changes in platelet parameters at various points in MM disease progression. Further investigation of the predictive and prognostic value of platelet dysregulation in such patients is warranted. Funding: Irish Research Council (GOIPG/2017/952) & TRAP Award, College of Medicine & Health, University College Cork.
Fiona M. Ross - One of the best experts on this subject based on the ideXlab platform.
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loss of 1p and rearrangement of myc are associated with progression of Smouldering Myeloma to Myeloma sequential analysis of a single case
Haematologica, 2009Co-Authors: Laura Chiecchio, Gianpaolo Dagrada, Rebecca K.m. Protheroe, David M. Stockley, A. Smith, Nicholas C.p. Cross, Christine J. Harrison, Kim Orchard, Fiona M. RossAbstract:We report serial genetic studies on a young female patient initially diagnosed with asymptomatic Smouldering Myeloma who progressed to symptomatic Myeloma 4.5 years after presentation. An unbalanced translocation, der(14)t(4;14)(p16;q32), was initially found in all plasma cells plus deletions of other chromosomal regions as detected by array-based comparative genomic hybridization. Deletion of chromosome 13 was observed in a minor population of plasma cells (<20%) for the first two years, increasing to 100% of plasma cells by the time of multiple Myeloma diagnosis. Loss of 1p and a rearrangement of MYC were first observed in a small population of plasma cells one year prior to the clinical diagnosis of multiple Myeloma, but these subclones increased rapidly in size to become the major population suggesting that they were directly involved in the transformation process. This case report provides a unique insight into the mechanisms of disease progression from Smouldering multiple Myeloma to multiple Myeloma.
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Loss of 1p and rearrangement of MYC are associated with progression of Smouldering Myeloma to Myeloma: sequential analysis of a single case
Haematologica, 2009Co-Authors: Laura Chiecchio, Gianpaolo Dagrada, Rebecca K.m. Protheroe, David M. Stockley, A. Smith, Kim H. Orchard, Nicholas C.p. Cross, Christine J. Harrison, Fiona M. RossAbstract:We report serial genetic studies on a young female patient initially diagnosed with asymptomatic Smouldering Myeloma who progressed to symptomatic Myeloma 4.5 years after presentation. An unbalanced translocation, der(14)t(4;14)(p16;q32), was initially found in all plasma cells plus deletions of other chromosomal regions as detected by array-based comparative genomic hybridization. Deletion of chromosome 13 was observed in a minor population of plasma cells (
Matthias A. Vanderkerken - One of the best experts on this subject based on the ideXlab platform.
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The diagnostic value of SE MRI and DWI of the spine in patients with monoclonal gammopathy of undetermined significance, Smouldering Myeloma and multiple Myeloma
European Radiology, 2014Co-Authors: Julie C. Dutoit, Matthias A. Vanderkerken, Joris Anthonissen, Frederick Dochy, Koenraad L. VerstraeteAbstract:Objectives To evaluate DWI of the bone marrow in the differentiation of monoclonal gammopathy of undetermined significance (MGUS), Smouldering Myeloma (SMM) and multiple Myeloma (MM). Methods The retrospective study includes 64 patients with MGUS, 27 with SMM, 64 with new MM and 12 controls. Signal intensity (SI) of spinal SE-MRI and DWI (b0-1000) as well as apparent diffusion coefficients (ADC) were measured in the T10 and L3. Qualitative assessment of b-images was performed by one experienced radiologist. Results ADC600 and ADC1000 are the best ADC values in differentiating patient groups ( p
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The diagnostic value of SE MRI and DWI of the spine in patients with monoclonal gammopathy of undetermined significance, Smouldering Myeloma and multiple Myeloma.
European radiology, 2014Co-Authors: Julie C. Dutoit, Matthias A. Vanderkerken, Joris Anthonissen, Frederick Dochy, Koenraad VerstraeteAbstract:To evaluate DWI of the bone marrow in the differentiation of monoclonal gammopathy of undetermined significance (MGUS), Smouldering Myeloma (SMM) and multiple Myeloma (MM). The retrospective study includes 64 patients with MGUS, 27 with SMM, 64 with new MM and 12 controls. Signal intensity (SI) of spinal SE-MRI and DWI (b0-1000) as well as apparent diffusion coefficients (ADC) were measured in the T10 and L3. Qualitative assessment of b-images was performed by one experienced radiologist. ADC600 and ADC1000 are the best ADC values in differentiating patient groups (p 50 % (p = 0.001). Only SIT2 for L3 can differentiate MGUS from SMM (p = 0.044) and PC%0-10 from PC%10-25 (p = 0.033). Qualitative interpretation of b1000 images allows differentiating MM patients from those with MGUS or SMM (p
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the diagnostic value of se mri and dwi of the spine in patients with monoclonal gammopathy of undetermined significance Smouldering Myeloma and multiple Myeloma
European Radiology, 2014Co-Authors: Julie C. Dutoit, Matthias A. Vanderkerken, Joris Anthonissen, Frederick Dochy, Koenraad VerstraeteAbstract:To evaluate DWI of the bone marrow in the differentiation of monoclonal gammopathy of undetermined significance (MGUS), Smouldering Myeloma (SMM) and multiple Myeloma (MM). The retrospective study includes 64 patients with MGUS, 27 with SMM, 64 with new MM and 12 controls. Signal intensity (SI) of spinal SE-MRI and DWI (b0-1000) as well as apparent diffusion coefficients (ADC) were measured in the T10 and L3. Qualitative assessment of b-images was performed by one experienced radiologist. ADC600 and ADC1000 are the best ADC values in differentiating patient groups (p 50 % (p = 0.001). Only SIT2 for L3 can differentiate MGUS from SMM (p = 0.044) and PC%0-10 from PC%10-25 (p = 0.033). Qualitative interpretation of b1000 images allows differentiating MM patients from those with MGUS or SMM (p < 0.001). Spinal SE-MRI can differentiate among MGUS, SMM, MM and control subjects. DWI based on the SI on b1000 images and ADC values is increased in MM compared to MGUS and SMM. Qualitative assessment of b-images can differentiate MM from MGUS or SMM. • ADC values are higher in patients with MM compared to MGUS • DWI parameters change late in disease evolution • DWI is sensitive but not specific in diagnosing patients with MM • Qualitative DWI assessment is good in detecting Myeloma patients