Abstract
Abstract
Background
The Myeloma Response Assessment and Diagnosis System (MY-RADS) guidelines establish a standardised acquisition and analysis pipeline for whole-body MRI (WB-MRI) in patients with myeloma. This is the first study to assess image quality in a multi-centre prospective trial using MY-RADS.
Methods
The cohort consisted of 121 examinations acquired across ten sites with a range of prior WB-MRI experience, three scanner manufacturers and two field strengths. Image quality was evaluated qualitatively by a radiologist and quantitatively using a semi-automated pipeline to quantify common artefacts and image quality issues. The intra- and inter-rater repeatability of qualitative and quantitative scoring was also assessed.
Results
Qualitative radiological scoring found that the image quality was generally good, with 94% of examinations rated as good or excellent and only one examination rated as non-diagnostic. There was a significant correlation between radiological and quantitative scoring for most measures, and intra- and inter-rater repeatability were generally good.
When the quality of an overall examination was low, this was often due to low quality diffusion-weighted imaging (DWI), where signal to noise ratio (SNR), anterior thoracic signal loss and brain geometric distortion were found as significant predictors of examination quality.
Conclusions
It is possible to successfully deliver a multi-centre WB-MRI study using the MY-RADS protocol involving scanners with a range of manufacturers, models and field strengths. Quantitative measures of image quality were developed and shown to be significantly correlated with radiological assessment. The SNR of DW images was identified as a significant factor affecting overall examination quality.
Trial registration
ClinicalTrials.gov, NCT03188172, Registered on 15 June 2017.
Critical relevance statement
Good overall image quality, assessed both qualitatively and quantitatively, can be achieved in a multi-centre whole-body MRI study using the MY-RADS guidelines.
Key points
• A prospective multi-centre WB-MRI study using MY-RADS can be successfully delivered.
• Quantitative image quality metrics were developed and correlated with radiological assessment.
• SNR in DWI was identified as a significant predictor of quality, allowing for rapid quality adjustment.
Graphical Abstract
Funder
Janssen
Celgene
Cancer Research UK
NIHR Biomedical Research Centre, Royal Marsden NHS Foundation Trust/Institute of Cancer Research
NIHR Royal Marsden/ICR Clinical Research Facility
Publisher
Springer Science and Business Media LLC
Subject
Radiology, Nuclear Medicine and imaging
Reference27 articles.
1. Messiou C, Porta N, Sharma B et al (2021) Prospective evaluation of whole-body MRI versus FDG PET/CT for lesion detection in participants with myeloma. Radiology 3:e210048
2. Hillengass J, Usmani S, Rajkumar SV et al (2019) International myeloma working group consensus recommendations on imaging in monoclonal plasma cell disorders. Lancet Oncol 20:e302–e312
3. National Institute for Health and Care Excellence (NICE) NG35 (2016) Myeloma: diagnosis and management
4. Messiou C, Hillengass J, Delorme S et al (2019) Guidelines for acquisition, interpretation, and reporting of whole-body MRI in myeloma: myeloma response assessment and diagnosis system (MY-RADS). Radiology 291:5–13
5. Wu C, Huang J, Xu W-B et al (2018) Discriminating depth of response to therapy in multiple myeloma using whole-body diffusion-weighted MRI with apparent diffusion coefficient: preliminary results from a single-center study. Acad Radiol 25:904–914