A new type of magnetic resonance imaging (MRI) scan, known as diffusion-weighted MRI, could improve care for myeloma and reduce reliance on bone marrow biopsies, which can be painful for patients and often fail to show doctors how far the disease has spread. The new whole-body, diffusion-weighted MRI scans showed the spread of cancer throughout the bone marrow of patients with myeloma more accurately than standard tests. The scans also showed whether the patients were responding to cancer treatments.
In the study, published in Radiology (2014; doi:10.1148/radiol.13131529), 26 patients had whole-body, diffusion-weighted MRI scans before and after treatment. In 86% of cases, experienced doctors trained in imaging were able to correctly identify whether patients responded to treatment. The doctors also correctly identified those patients who were not responding to treatment 80% of the time.
Using the scanning technique, doctors could pinpoint exactly where the cancer was in the bones, with the results available immediately. Conventional tests include bone marrow biopsies and blood tests but neither shows accurately where in the bones the cancer is present.
The researchers also assessed changes visible on the MRI scans using the Apparent Diffusion Coefficient (ADC), which measures the restriction of water movement within tissues. Changes in this measurement correctly identified treatment response for 24 of 25 patients with myeloma.
“This is the first time we’ve been able to obtain information from all the bones in the entire body for myeloma in one scan without having to rely on individual bone [radiographs]. It enables us to measure the involvement of individual bones and follow their response to treatment,” said Nandita deSouza, MD, PhD, Professor of Translational Imaging at The Institute of Cancer Research and Honorary Consultant at The Royal Marsden in London, UK.
DeSouza continued, “The results can be visualized immediately; we can look on the screen and see straight away where the cancer is and measure how severe it is. The scan is better than blood tests, which don’t tell us in which bones the cancer is located. It also reduces the need for uncomfortable biopsies, which don’t reveal the extent or severity of the disease.”
“Finding kinder ways to monitor how patients respond to treatment is really important, particularly in the case of myeloma where taking bone marrow samples can be painful. This research demonstrates how an advanced imaging technique could provide a whole-skeleton ‘snapshot’ to track the response of tumors in individual bones. Finding ways to make treatments gentler and improve the experience for patients is an important focus for Cancer Research UK and the research we fund,” said Julia Frater, Cancer Research UK’s Senior Cancer Information Nurse.