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Multiple myeloma AND imaging

Giulio Caracciolo, Sara Palchetti, Luca Digiacomo, Riccardo Zenezini Chiozzi, Anna Laura Capriotti, Heinz Amenitsch, Paolo Maria Tentori, Valentina Palmieri, Massimiliano Papi, Francesco Cardarelli, Daniela Pozzi, Aldo Laganà
More than twenty years after its approval by the Food and Drug Administration (FDA) liposomal doxorubicin (DOX) is still the drug of choice for the treatment of breast cancer and other conditions such as ovarian cancer and multiple myeloma. Yet, despite the efforts, liposomal DOX did not satisfy expectations at the clinical level. When liposomal drugs enter a physiological environment, their surface gets coated by a dynamic biomolecular corona (BC). The BC changes liposome's synthetic identity, providing it with a new one, referred to as 'biological identity' (size, aggregation state, and BC composition)...
June 15, 2018: ACS Applied Materials & Interfaces
Arjun Lakshman, S Vincent Rajkumar, Francis K Buadi, Moritz Binder, Morie A Gertz, Martha Q Lacy, Angela Dispenzieri, David Dingli, Amie L Fonder, Suzanne R Hayman, Miriam A Hobbs, Wilson I Gonsalves, Yi Lisa Hwa, Prashant Kapoor, Nelson Leung, Ronald S Go, Yi Lin, Taxiarchis V Kourelis, Rahma Warsame, John A Lust, Stephen J Russell, Steven R Zeldenrust, Robert A Kyle, Shaji K Kumar
In 2014, the International Myeloma Working Group reclassified patients with smoldering multiple myeloma (SMM) and bone marrow-plasma cell percentage (BMPC%) ≥ 60%, or serum free light chain ratio (FLCr) ≥ 100 or >1 focal lesion on magnetic resonance imaging as multiple myeloma (MM). Predictors of progression in patients currently classified as SMM are not known. We identified 421 patients with SMM, diagnosed between 2003 and 2015. The median time to progression (TTP) was 57 months (CI, 45-72)...
June 12, 2018: Blood Cancer Journal
Braden J Lawrence, Emily L Petersen, Wayne G Riches, David C Pfeiffer
Plasmacytomas are rare immunoproliferative monoclonal plasma cell diseases of lymphoid lineage that may present in an isolated or systemic manner. Systemic involvement is much more common than occurrences isolated to a particular organ, and for this reason, it is imperative to rule out systemic involvement for osseous and nonosseous isolated neoplasms. These neoplasms present unique challenges due to their location, extent of involvement, vague presentation, and dearth of treatment protocol. We report the case of a 69-year-old man who developed chronic kidney disease stage 4 between 2009 and 2012...
June 6, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Aleksander Kosmala, Andreas Max Weng, Bernhard Krauss, Stefan Knop, Thorsten Alexander Bley, Bernhard Petritsch
OBJECTIVES: Bone marrow imaging patterns in patients with multiple myeloma possess prognostic and potential therapeutic relevance. We aim to evaluate whether different magnetic resonance imaging (MRI) patterns also result in different bone marrow dual-energy computed tomography (DECT) virtual non-calcium (VNCa) attenuation values. METHODS: The institutional review board approved this study. Written informed consent was obtained from all participants. 53 patients with plasma cell disorders (24 with normal imaging pattern, 24 with focal infiltration, 5 with diffuse infiltration) and 21 control subjects sequentially underwent DECT and MRI of the axial skeleton...
June 7, 2018: European Radiology
Annika M A Berends, Michiel N Kerstens, Janne W Bolt, Thera P Links, Esther Korpershoek, Ronald R de Krijger, Annemiek M E Walenkamp, Walter Noordzij, Boudewijn van Etten, Gursah Kats-Ugurlu, Ah Brouwers, A N A van der Horst-Schrivers
BACKGROUND/AIM: Positron Emission Tomography (PET) with 6-[18F]fluor-L-3,4-dihydroxyphenylalanine (18F-FDOPA) has been shown to be a useful imaging tool with a high sensitivity for the visualization of neuroendocrine tumors (NETs). 18F-FDOPA uptake in tumors other than NETs has been suggested previously, but data on this phenomenon are limited. We therefore studied the non-physiological, false-positive uptake of 18F-FDOPA in a large population of patients with a NET or with a high clinical suspicion of harboring a NET...
June 6, 2018: European Journal of Endocrinology
Mohammad Mahmoudian, Hadi Valizadeh, Parvin Zakeri-Milani
Bortezomib (BTZ), a proteasome inhibitor, is clinically used for the treatment of multiple myeloma and mantle cell lymphoma via intravenous or subcutaneous administration. Since BTZ has limited intestinal permeability, in this study, solid lipid nanoparticles (SLNs) were selected as lipid carrier to improve the intestinal permeability of BTZ. The nanoparticles were prepared by hot oil-in-water emulsification method and characterized for physicochemical properties. Moreover, in situ single-pass intestinal perfusion technique was used for intestinal permeability studies...
June 7, 2018: Drug Development and Industrial Pharmacy
Markus Wennmann, Laurent Kintzelé, Marie Piraud, Bjoern H Menze, Thomas Hielscher, Johannes Hofmanninger, Barbara Wagner, Hans-Ulrich Kauczor, Maximilian Merz, Jens Hillengass, Georg Langs, Marc-André Weber
The purpose of this study was to improve risk stratification of smoldering multiple myeloma patients, introducing new 3D-volumetry based imaging biomarkers derived from whole-body MRI. Two-hundred twenty whole-body MRIs from 63 patients with smoldering multiple myeloma were retrospectively analyzed and all focal lesions >5mm were manually segmented for volume quantification. The imaging biomarkers total tumor volume, speed of growth (development of the total tumor volume over time), number of focal lesions, development of the number of focal lesions over time and the recent imaging biomarker '>1 focal lesion' of the International Myeloma Working Group were compared, taking 2-year progression rate, sensitivity and false positive rate into account...
May 18, 2018: Oncotarget
Arzu Cengiz, Hayri Üstün Arda, Firuzan Döğer, İrfan Yavaşoğlu, Yakup Yürekli, Ali Zahit Bolaman
OBJECTIVE: The aim of this study was to evaluate the association between the degree of F-18 FDG uptake and CD38, CD138 expression in myeloma cells in bone marrow and other clinical parameters in patients with multiple myeloma (MM). MATERIALS AND METHODS: Patients with the diagnosis MM who underwent 18F-FDG PET/CT for initial staging were evaluated retrospectively. We analyzed a total of 42 patients (43-83 years-old, mean:64.4 ±9.9). Hematological and biochemical tests including hemoglobin (Hb), hematocrit (Htc), C-reactive protein (CRP), beta2-microglobulin (β2M), creatinine (Cr), albumin, calcium (Ca), lactate dehydrogenase (LDH), erythrocyte sedimentation rate were recorded...
May 28, 2018: Turkish Journal of Haematology: Official Journal of Turkish Society of Haematology
Mingge Zhou, Yumei Chen, Jianjun Liu, Gang Huang
Purpose: To demonstrate the relationship between the etiologies of increased diffuse bone marrow (BM) 18 F-FDG uptake and PET/CT imaging/clinical features, as well as to explore a predicting model of BM malignant infiltration (MI) based on decision tree. Methods: 84 patients with increased diffuse BM uptake were retrospectively enrolled. Their complete case record and PET/CT images were reviewed, with the maximal standardized uptake values of bone marrow (SUVmaxBM) and other imaging/clinical features were noted...
2018: Journal of Cancer
M A Khan, G Deib, B Deldar, A M Patel, J S Barr
BACKGROUND AND PURPOSE: Painful spinal metastases are a common cause of cancer-related morbidity. Percutaneous ablation presents an attractive minimally invasive alternative to conventional therapies. We performed a retrospective review of 69 patients with 102 painful spinal metastases undergoing microwave ablation and cementoplasty to determine the efficacy and safety of this treatment. MATERIALS AND METHODS: Procedures were performed between January 2015 and October 2016 with the patient under general anesthesia using image guidance for 102 spinal metastases in 69 patients in the following areas: cervical ( n = 2), thoracic ( n = 50), lumbar ( n = 34), and sacral ( n = 16) spine...
May 24, 2018: AJNR. American Journal of Neuroradiology
Leo Rasche, Edgardo J Angtuaco, Terri L Alpe, Grant H Gershner, James E McDonald, Rohan S Samant, Manoj Kumar, Rudy Van Hemert, Joshua Epstein, Shayu Deshpande, Ruslana Tytarenko, Shmuel Yaccoby, Jens Hillengass, Sharmilan Thanendrarajan, Carolina Schinke, Frits van Rhee, Maurizio Zangari, Brian A Walker, Bart Barlogie, Gareth J Morgan, Faith E Davies, Niels Weinhold
Spatial intra-tumor heterogeneity is frequently seen in Multiple Myeloma (MM) and poses a significant challenge for risk classifiers, which rely on tumor samples from the iliac crest. As biopsy based assessment of multiple skeletal sites is difficult, alternative strategies for risk stratification are required. Recently, the size of focal lesions (FL) was shown to be a surrogate marker for spatial heterogeneity, suggesting that data from medical imaging could be used to improve risk stratification approaches...
May 21, 2018: Blood
Alexandre Detappe, Mark Bustoros, Tarek H Mouhieddine, P Peter Ghoroghchian
In the past decades, considerable progress has been made in our understanding and treatment of multiple myeloma. Several challenges remain including our abilities to longitudinally image tumor responses to treatment, to combine various therapeutic agents with different mechanisms of action but with overlapping toxicities, and to efficiently harness the power of the immune system to augment remission and/or to induce permanent cures. Nanomedicine may help to address many of these outstanding issues, affording novel diagnostic capabilities and offering disruptive technologies that promise to revolutionize treatment...
May 14, 2018: Trends in Molecular Medicine
Diego Andres Adrianzen Herrera, Shlomit Goldberg-Stein, Alexander Sankin, Judy Sarungbam, Janaki Sharma, Benjamin A Gartrell
The radiographic appearance of bone metastases is usually determined by tumor histology and can be osteolytic, osteoblastic, or mixed. We present a patient with coexistent bone metastasis from multiple myeloma and prostate adenocarcinoma who exhibited synchronous bone involvement of both histologies within the same bone lesion, a rare phenomenon that has not been previously reported and led to atypical radiographic findings. The radiograph of a 71-year-old man with thigh swelling and pain demonstrated a lytic femoral lesion...
2018: Frontiers in Oncology
Neeta Pandit-Taskar
Imaging plays a key role in assessment of myeloma. Osteolytic bone lesions are optimally assessed using structural imaging, however the structural changes lag the functional changes in the disease. Functional imaging with fluoro deoxy glucose (FDG) positron emission tomography (PET) computerized tomography (CT) is useful in assessment of high-risk myeloma. FDG PET provides prognostic information and is helpful in monitoring response to therapy. However, it is nonspecific and may not be optimal in assessing treatment response to immunotherapeutic agents...
January 2018: Seminars in Hematology
Jens Hillengass, Maximilian Merz, Stefan Delorme
The increasing percentage of patients achieving deep responses in multiple myeloma has led to the need for more sophisticated instruments to measure residual disease as a potential source of relapse. As minimal residual disease assessment is mostly performed on a bone marrow specimen from a certain area of the body, such samples have the limitation that they might not really represent the actual tumor burden, because focal accumulations of malignant cells might be either hit or missed. Magnetic resonance imaging is a highly sensitive technique for the assessment of tumor burden and can be performed as whole-body protocol, overcoming the problem of sampling error for minimal residual disease assessment...
January 2018: Seminars in Hematology
Ola Landgren
Minimal residual disease (MRD) testing in multiple myeloma is here to stay. Studies show that MRD negativity is consistently associated with longer progression-free survival (PFS). It is just a matter of time until MRD negativity will become a regulatory endpoint for drug approval. Until that can happen, more analysis will be required to define the exact details of MRD in the regulatory setting. For example, for randomized studies there is need to define the amount of improvement in MRD negativity between the experimental arm and the control arm at a given time-point for a drug to obtain regulatory accelerated approval...
January 2018: Seminars in Hematology
Jonathan Bulzan, Jonathan Revels, Kathy Byun
It is important to understand normal and abnormal radiotracer biodistribution patterns in patients who undergo cardiac Tc-2-methoxyisobutyl-isonitrile (Tc-sestamibi) scans to provide important clinical guidance. Our case describes a 75-year-old man with a history of multiple myeloma in remission, who presented to the emergency department for unrelated chest pain and shortness of breath. The patient underwent a nuclear cardiac stress test with Tc-sestamibi scintigraphy as part of his cardiac workup. The images demonstrated diffuse radiotracer uptake in the skeletal structures raising concern for progression of multiple myeloma, of which, subsequent biopsy confirmed the presence of recurrent disease...
May 7, 2018: Clinical Nuclear Medicine
Thomas Le Bihan, Anne-Sophie Navarro, Nathalie Le Bris, Patricia Le Saëc, Sébastien Gouard, Ferid Haddad, Jean-François Gestin, Michel Chérel, Alain Faivre-Chauvet, Raphaël Tripier
In view of the excellent copper(ii) and 64-copper(ii) complexation of a TE1PA ligand, a monopicolinate cyclam, in both aqueous medium and in vivo, we looked for a way to make it bifunctional, while maintaining its chelating properties. Overcoming the already known drawback of grafting via its carboxyl group, which is essential to the overall properties of the ligand, a TE1PA bifunctional derivative bearing an additional isothiocyanate coupling function on a carbon atom of the macrocyclic ring was synthesized...
June 13, 2018: Organic & Biomolecular Chemistry
Deep Hathi, Elizabeth DeLassus, Samuel Achilefu, Jonathan McConathy, Monica Shokeen
Multiple myeloma (MM) is a debilitating neoplasm of terminally differentiated plasma B-cells that has resulted in over 13,000 deaths in 2017 alone. Combination therapies involving melphalan, a small molecule DNA alkylating agent, are commonly prescribed to patients with relapsed/refractory MM, which necessitates the stratification of responding patients to minimize toxicities and improve quality of life. Here, we evaluated the use of 18 F-FDOPA, a clinically available positron emission tomography (PET) radiotracer with specificity to the L-type amino acid transporter-1 (LAT1), which also mediates melphalan uptake, for imaging melphalan therapy response in a preclinical immunocompetent model of MM...
April 26, 2018: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
Mohammad Abd Alkhalik Basha, Maged Abdel Gelil Hamed, Rania Refaat, Mohamad Zakarya AlAzzazy, Manar A Bessar, Elshaimaa Mohamed Mohamed, Ayman F Ahmed, Heba Fathy Tantawy, Khaled Mohamed Altaher, Ahmed Ali Obaya, Amira Hamed Mohamed Afifi
OBJECTIVE: To determine the diagnostic accuracy of WB-MRI and 18 F-FDG PET/CT in detecting infiltration pattern, disease activity, and response to treatment in patients with multiple myeloma (MM). MATERIALS AND METHODS: Fifty-six patients with confirmed MM were included in the present study for pre-treatment evaluation. Among these individuals, 22 patients were available for the post-treatment evaluation of response to therapy. All patients were imaged with both WB-MRI and 18 F-FDG PET/CT...
June 2018: Japanese Journal of Radiology
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