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@ARTICLE{Kloth:127139,
      author       = {J. K. Kloth$^*$ and J. Hillengass$^*$ and K. Listl and K.
                      Kilk and T. Hielscher$^*$ and O. Landgren and S. Delorme$^*$
                      and H. Goldschmidt$^*$ and H.-U. Kauczor$^*$ and M.-A.
                      Weber$^*$},
      title        = {{A}ppearance of monoclonal plasma cell diseases in
                      whole-body magnetic resonance imaging and correlation with
                      parameters of disease activity.},
      journal      = {International journal of cancer},
      volume       = {135},
      number       = {10},
      issn         = {0020-7136},
      address      = {Bognor Regis},
      publisher    = {Wiley-Liss},
      reportid     = {DKFZ-2017-03165},
      pages        = {2380 - 2386},
      year         = {2014},
      abstract     = {The aim of our study was to assess in which way different
                      infiltration patterns of monoclonal plasma cell diseases in
                      whole-body (wb) magnetic resonance imaging (MRI) are
                      associated with clinical stages, plasma cell content in bone
                      marrow samples and established serum markers of disease
                      activity. Institutional review board approval was obtained.
                      We performed wb-MRI in 547 consecutive, unselected and
                      untreated patients with monoclonal gammopathy of
                      undetermined significance (MGUS, n=138), smoldering myeloma
                      (SMM, n=157) and multiple myeloma (MM, n=252) on two 1.5 T
                      MRI-scanners with body array coils. The studies were
                      evaluated in consensus by two experienced radiologists
                      blinded to the diagnosis. We observed focal lesions in
                      $23.9\%$ (MGUS), $34.4\%$ (SMM) and $81.3\%$ (MM),
                      respectively. A diffuse infiltration pattern was detected in
                      $38.4\%,$ $45.9\%$ and $71\%,$ respectively. The differences
                      between all infiltration patterns were significant
                      (p<0.0001). The presence of focal lesions and the presence
                      of a diffuse bone marrow infiltration was associated with an
                      increased plasma cell percentage in bone marrow samples
                      (median $22\%$ vs. $14\%,$ $26\%$ vs. $10\%,$ both p<0.0001)
                      and monoclonal protein concentration (median 18 g/dl vs. 13
                      g/dl, p=0.003, 20 g/dl vs. 11 g/dl, p<0.0001). Further
                      categorization of the diffuse infiltration patterns in
                      wb-MRI into 'salt-and-pepper,' moderate and severe
                      identified significant associations with M-protein (median
                      g/dl for S+P/moderate/severe 23/18/25, p=0.04), plasma cell
                      percentage in the bone marrow (median $25\%/24\%/40\%,$
                      p=0.02), and age (median years 67/60/57, p<0.0001). Bone
                      marrow infiltration in wb-MRI is significantly different
                      between the various stages of plasma cell disease and
                      correlates well with established markers of disease
                      activity.},
      keywords     = {Biomarkers, Tumor (NLM Chemicals) / Myeloma Proteins (NLM
                      Chemicals) / multiple myeloma M-proteins (NLM Chemicals)},
      cin          = {E010 / C060},
      ddc          = {610},
      cid          = {I:(DE-He78)E010-20160331 / I:(DE-He78)C060-20160331},
      pnm          = {315 - Imaging and radiooncology (POF3-315)},
      pid          = {G:(DE-HGF)POF3-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:24706394},
      doi          = {10.1002/ijc.28877},
      url          = {https://inrepo02.dkfz.de/record/127139},
}