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JCO：磁共振成像和[18F]氟脱氧葡萄糖正电子发射断层扫描在有症状多发性骨髓瘤患者的诊断与维持治疗前的前瞻性评估研究：IMAJEM研究结果

2017-07-19 xuyihan MedSci原创

磁共振正电子发射断层扫描多发性骨髓瘤
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众所周知磁共振成像（MRI）和正电子发射断层扫描（PET-CT）是多发性骨髓瘤（MM）患者重要的检查手段。2017年7月在JCO上发表的一篇文章对MM患者进行了一项前瞻性研究，目的是比较MRI和PET-CT对骨损伤的诊断及这些技术的预后价值。

众所周知磁共振成像（MRI）和正电子发射断层扫描（PET-CT）是多发性骨髓瘤（MM）患者重要的检查手段。2017年7月在JCO上发表的一篇文章对MM患者进行了一项前瞻性研究，目的是比较MRI和PET-CT对骨损伤的诊断及这些技术的预后价值。

134例患者接受了来那度胺、硼替佐米、地塞米松（RVD）加或不加自体干细胞移植的联合治疗，继而来那度胺维持治疗。在诊断时、3次RVD循环后及维持治疗前进行PET-CT和MRI检查。主要终点是MRI和PET-CT骨损伤检测的诊断。次要终点包括两者对于无进展生存期（PFS）和总生存期（OS）的预后影响。

在诊断上，134例患者中127例（95%）MRI阳性，122例（91%）PET-CT阳性。3次RVD循环后和维持治疗前MRI正常化并不能预测PFS和OS，而3次RVD循环后32%基线评估阳性的患者PET-CT恢复正常，且这组患者的PFS提高（30个月PFS，78.7%v56.8%）。62%基线评估阳性的患者PET-CT在维持治疗前恢复正常，且与更好的PFS和OS相关。髓外病变诊断是PFS和OS的独立预后因素，而PET-CT在维持治疗前正常化是PFS的独立预后因素。

在检测骨病变的诊断上，PET-CT与MRI的价值无异。PET-CT是评估新发骨髓瘤预后的有力工具。

原始出处：

Philippe Moreau.et al. Prospective Evaluation of Magnetic Resonance Imaging and [18F]Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography at Diagnosis and Before Maintenance Therapy in Symptomatic Patients With Multiple Myeloma Included in the IFM/DFCI 2009 Trial： Results of the IMAJEM Study.J CLIN ONCOL.2017.

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    2017-10-01 1249894fm84暂无昵称

    #研究结果#

    0

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    2018-06-03 jml2009

    #多发性#

    0

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    2018-05-22 lidong40

    #JCO#

    0

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    2018-06-09 1508842480_96220437

    #前瞻性#

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    2017-07-21 1696533704_45270454

    #磁共振#

    0

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首都医科大学宣武医院神经内科韩璎教授团队利用多模态磁共振成像技术发现，主观认知下降人群在大脑中阿尔茨海默病易受损的默认网络区域有功能活动增强，可能为弥补情景记忆的减退起到功能代偿。该研究为早期识别主观认知下降提供了影像学证据，并揭示了主观认知下降人群总体记忆水平仍能维持在正常范围内的代偿机制。相关研究成果日前发表于国际权威期刊《Radiology》上。主观认知下降，即自我感觉记忆力减退，比如有时想