Ces radiol. 2010, 64(3):203-212

Correlation of whole-body MRI to Durie/Salmon staging system in patients with monoclonal gammopathy of uncertain significance or multiple myelomaOriginal article

Miroslav Heřman1, Jan Hrbek1, Vlastimil Ščudla2, Jaroslav Bačovský2, Tomáš Pika2, Jiří Minařík2
1 Radiologická klinika LF UP a FN, Olomouc
2 III. interní klinika LF UP a FN, Olomouc

Aim: To compare new staging system Durie/Salmon PLUS determined on the basis of whole-body MRI and level of serum creatinine with original Durie/Salmon staging system and find their correlation.

Method: Whole body MRI, plane films and spectrum of laboratory examinations were performed in 82 patients with monoclonal gammopathy of uncertain significance or multiple myeloma and Durie/Salmon stage was stated. To assess MRI findings the skeleton was divided into 9 regions: skull, cervical spine, thoracic spine, lumbosacral spine, pelvis, sternum, clavicles and ribs, upper extremities, lower extremities. Durie/Salmon PLUS stage was determined according to the number of skeletal lesions and diffuse changes seen on MRI and serum creatinine level. Durie/Salmon PLUS stage was compared with Durie/Salmon stage by Cohen's kappa coefficient and supplemented by 95% confidence interval.

Results: Kappa coefficient was found to be 0.479 (p < 0.0001), 95% confidence interval 0.355-0.602. Both classifications showed agreement in 56.1% (in 46 from 82 cases). More advanced changes were found on MRI in 28 out of 36 cases (77.8%) (MRI found skeletal changes which were not discovered by other methods), in 8 patients (22.2%) MRI findings were assessed as less advanced.

Conclusion: Whole-body MRI brings new information about skeletal involvement particularly in early and unclear cases with monoclonal gammopathy of uncertain significance and multiple myeloma. This is probably the main reason why we found only average correlation between staging systems Durie/Salmon and Durie/Salmon PLUS stated on the basis of whole-body MRI.

Keywords: multiple myeloma, monoclonal gammopathy of uncertain significance, magnetic resonance, whole body imaging
Grants and funding:

Práce byla podpořena grantem IGA MZ ČR č. NR 9489-3.

Accepted: June 15, 2010; Published: September 1, 2010  Show citation

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Heřman M, Hrbek J, Ščudla V, Bačovský J, Pika T, Minařík J. Correlation of whole-body MRI to Durie/Salmon staging system in patients with monoclonal gammopathy of uncertain significance or multiple myeloma. Ces radiol. 2010;64(3):203-212.
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