Background The purpose of our study was to explore and compare the tumor burden of different bone marrow infiltration patterns and evaluate the feasibility of apparent diffusion coefficient (ADC) value to identify patterns in multiple myeloma (MM). Patients and methods Ninety-three patients with newly diagnosed multiple myeloma and 23 controls had undergone routine magnetic resonance imaging (MRI) and diffusion-weighted MRI (DWI) from January 2019 to November 2020. Five bone marrow (BM) infiltration patterns were allocated according to routine MRI. The laboratory data and ADC values of patterns were analyzed and compared. ROC analysis was used to establish the best diagnostic ADC threshold value for identifying these patterns and distinguishing normal pattern from controls. Besides, the correlation between the ADC values of diffuse pattern and the plasma cells ratio was assessed. Results The values of hemoglobin, beta-2 microglobulin (β2-MG), plasma cell, M protein, the percentages of stage, high-risk fluorescence in situ hybridization, and ADC values showed significant difference among patterns. ADCmean at a specific value (368.5×10−6 mm2/s) yielded a maximum specificity (95.5%) and sensitivity (92.0%) in diagnosing MM. A specific value (335.5×10−6mm2/s) yielded a maximum specificity (84.7%) and sensitivity (88.0%) in discriminating visually normal pattern in MM from controls. There was a moderate positive correlation between the plasma cells ratio and ADCs of diffuse infiltration patterns (r = 0.648, P < 0.001). Conclusions The bone marrow infiltration patterns in MM patients can indicate the tumor burden and ADC value has the ability to discriminate these patterns objectively.

中文翻译：

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多发性骨髓瘤骨髓浸润模式的表观扩散系数测量用于评估肿瘤负荷——可行性研究

背景我们研究的目的是探索和比较不同骨髓浸润模式的肿瘤负荷，并评估表观扩散系数（ADC）值识别多发性骨髓瘤（MM）模式的可行性。患者和方法 2019 年 1 月至 2020 年 11 月，93 名新诊断的多发性骨髓瘤患者和 23 名对照患者接受了常规磁共振成像 (MRI) 和弥散加权 MRI (DWI)。根据情况分配了 5 种骨髓 (BM) 浸润模式常规 MRI。对模式的实验室数据和ADC值进行了分析和比较。ROC 分析用于建立最佳诊断 ADC 阈值，用于识别这些模式并将正常模式与对照区分开来。此外，还评估了弥散型ADC值与浆细胞比率之间的相关性。结果血红蛋白、β2微球蛋白（β2-MG）、浆细胞、M蛋白、分期百分率、高危荧光原位杂交、ADC值等各模式间差异有统计学意义。模数转换器意思是在特定值（368.5×10−6毫米2/s) 在诊断 MM 时产生了最大的特异性 (95.5%) 和敏感性 (92.0%)。具体值（335.5×10−6毫米2/s) 在区分 MM 和对照的视觉正常模式方面产生了最大特异性 (84.7%) 和敏感性 (88.0%)。浆细胞比例与弥漫性浸润模式的 ADC 呈中度正相关（r = 0.648，P < 0.001）。结论 MM患者的骨髓浸润模式可以提示肿瘤负荷，ADC值能够客观区分这些模式。