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  1. Book ; Thesis: Analyse von Ganzkörper-Magnetresonanztomographie-Bildgebungen bei monoklonaler Plasmazellerkrankungen

    Wennmann, Markus

    3D-Volumetrie-basierte Magnetresonanztomographie-Biomarker zur Verbesserung der Risikostratifizierung von Patienten mit Smoldering Multiple Myeloma

    2018  

    Institution Universität Heidelberg
    Author's details vorgelegt von: Markus Sebastian Wennmann ; Doktorvater: Herr Prof. Dr. med. Marc-André Weber, M.Sc
    Language German
    Size IX, 110 Blätter, Illustrationen, Diagramme, 30 cm
    Publishing place Heidelberg
    Publishing country Germany
    Document type Book ; Thesis
    Thesis / German Habilitation thesis Dissertation, Ruprecht-Karls-Universität Heidelberg, 2019
    HBZ-ID HT020123914
    Database Catalogue ZB MED Medicine, Health

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  2. Article ; Online: Potenzial von Radiomics und künstlicher Intelligenz in der Myelombildgebung : Entwicklung automatischer, umfassender, objektiver Skelettanalysen aus Ganzkörperbildgebungsdaten.

    Wennmann, Markus / Murray, Jacob M

    Der Radiologe

    2021  Volume 62, Issue 1, Page(s) 44–50

    Abstract: Clinical/methodical issue: Multiple myeloma can affect the complete skeleton, which makes whole-body imaging necessary. With the current assessment of these complex datasets by radiologists, only a small part of the accessible information is assessed ... ...

    Title translation Potential of radiomics and artificial intelligence in myeloma imaging : Development of automatic, comprehensive, objective skeletal analyses from whole-body imaging data.
    Abstract Clinical/methodical issue: Multiple myeloma can affect the complete skeleton, which makes whole-body imaging necessary. With the current assessment of these complex datasets by radiologists, only a small part of the accessible information is assessed and reported.
    Standard radiological methods: Depending on the question and availability, computed tomography (CT), magnetic resonance imaging (MRI), or positron emission tomography (PET) is performed and the results are then visually examined by radiologists.
    Methodological innovations: A combination of automatic skeletal segmentation using artificial intelligence and subsequent radiomics analysis of each individual bone have the potential to provide automatic, comprehensive, and objective skeletal analyses.
    Performance: A few automatic skeletal segmentation algorithms for CT already show promising results. In addition, first studies indicate correlations between radiomics features of bone and bone marrow with established disease markers and therapy response.
    Achievements: Artificial intelligence (AI) and radiomics algorithms for automatic skeletal analysis from whole-body imaging are currently in an early phase of development.
    MeSH term(s) Artificial Intelligence ; Humans ; Magnetic Resonance Imaging ; Multiple Myeloma/diagnostic imaging ; Positron-Emission Tomography ; Tomography, X-Ray Computed ; Whole Body Imaging
    Language German
    Publishing date 2021-12-10
    Publishing country Germany
    Document type Journal Article ; Review
    ZDB-ID 505520-9
    ISSN 1432-2102 ; 0033-832X
    ISSN (online) 1432-2102
    ISSN 0033-832X
    DOI 10.1007/s00117-021-00940-1
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  3. Article ; Online: (Smoldering) multiple myeloma: mismatch between tumor load estimated from bone marrow biopsy at iliac crest and tumor load shown by MRI.

    Bauer, Fabian / Sauer, Sandra / Weinhold, Niels / Delorme, Stefan / Wennmann, Markus

    Skeletal radiology

    2023  Volume 52, Issue 12, Page(s) 2513–2518

    Abstract: In multiple myeloma and its precursor stages, precise quantification of tumor load is of high importance for diagnosis, risk assessment, and therapy response evaluation. Both whole-body MRI, which allows to investigate the complete bone marrow of a ... ...

    Abstract In multiple myeloma and its precursor stages, precise quantification of tumor load is of high importance for diagnosis, risk assessment, and therapy response evaluation. Both whole-body MRI, which allows to investigate the complete bone marrow of a patient, and bone marrow biopsy, which is commonly used to assess the histologic and genetic status, are relevant methods for tumor load assessment in multiple myeloma. We report on a series of striking mismatches between the plasma cell infiltration estimating the tumor load from unguided biopsies of the bone marrow at the posterior iliac crest and the tumor load assessment from whole-body MRI.
    MeSH term(s) Humans ; Bone Marrow/diagnostic imaging ; Bone Marrow/pathology ; Multiple Myeloma/diagnostic imaging ; Multiple Myeloma/pathology ; Ilium/diagnostic imaging ; Ilium/pathology ; Tumor Burden ; Magnetic Resonance Imaging/methods ; Biopsy
    Language English
    Publishing date 2023-06-10
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 527592-1
    ISSN 1432-2161 ; 0364-2348
    ISSN (online) 1432-2161
    ISSN 0364-2348
    DOI 10.1007/s00256-023-04383-8
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  4. Article ; Online: Identification of focal lesion characteristics in MRI which indicate presence of corresponding osteolytic lesion in CT in patients with multiple myeloma.

    Hildenbrand, Nina / Klein, André / Maier-Hein, Klaus / Wennmann, Markus / Delorme, Stefan / Goldschmidt, Hartmut / Hillengass, Jens

    Bone

    2023  Volume 175, Page(s) 116857

    Abstract: Purpose: The presence of bone marrow focal lesions and osteolytic lesions in patients with multiple myeloma (MM) is of high prognostic significance for their individual outcome. It is not known yet why some focal lesions seen in MRI, reflecting ... ...

    Abstract Purpose: The presence of bone marrow focal lesions and osteolytic lesions in patients with multiple myeloma (MM) is of high prognostic significance for their individual outcome. It is not known yet why some focal lesions seen in MRI, reflecting localized bone marrow infiltration of myeloma cells, remain non-lytic, whereas others are associated with destruction of mineralized bone. In this study, we analyzed MRI characteristics of manually segmented focal lesions in MM patients to identify possible features that might discriminate lytic and non-lytic lesions.
    Method: The initial cohort included a total of 140 patients with different stages of MM who had undergone both whole-body MRI and whole-body low-dose CT within 30 days, and of which 29 satisfied the inclusion criteria for this study. Focal lesions in MRI and corresponding osteolytic areas in CT were segmented manually. Analysis of the lesions included volume, location and first order texture features analysis.
    Results: There were significantly more lytic lesions in the axial skeleton than in the appendicular skeleton (p = 0.037). Out of 926 focal lesions in the axial skeleton seen on MRI, 544 (59.3 %) were osteolytic. Analysis of volume and first order texture features showed differences in texture and volume between focal lesions in MRI with and without local bone destruction in CT, but these findings were not statistically significant.
    Conclusions: Neither morphological imaging characteristics like size and location nor first order texture features could predict whether focal lesions seen in MRI would exhibit corresponding bone destruction in CT. Studies performing biopsies of such lesions are ongoing.
    MeSH term(s) Humans ; Multiple Myeloma/diagnostic imaging ; Multiple Myeloma/pathology ; Bone Marrow/diagnostic imaging ; Bone Marrow/pathology ; Tomography, X-Ray Computed ; Magnetic Resonance Imaging ; Prognosis
    Language English
    Publishing date 2023-07-22
    Publishing country United States
    Document type Journal Article
    ZDB-ID 632515-4
    ISSN 1873-2763 ; 8756-3282
    ISSN (online) 1873-2763
    ISSN 8756-3282
    DOI 10.1016/j.bone.2023.116857
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    Zs.MO 332: Show issues

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  5. Article ; Online: Reproducible Radiomics Features from Multi-MRI-Scanner Test-Retest-Study: Influence on Performance and Generalizability of Models.

    Wennmann, Markus / Rotkopf, Lukas T / Bauer, Fabian / Hielscher, Thomas / Kächele, Jessica / Mai, Elias K / Weinhold, Niels / Raab, Marc-Steffen / Goldschmidt, Hartmut / Weber, Tim F / Schlemmer, Heinz-Peter / Delorme, Stefan / Maier-Hein, Klaus / Neher, Peter

    Journal of magnetic resonance imaging : JMRI

    2024  

    Language English
    Publishing date 2024-05-11
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1146614-5
    ISSN 1522-2586 ; 1053-1807
    ISSN (online) 1522-2586
    ISSN 1053-1807
    DOI 10.1002/jmri.29442
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  6. Article ; Online: Same-day repeatability and Between-Sequence reproducibility of Mean ADC in PI-RADS lesions.

    Zhang, Kevin Sun / Neelsen, Christian Jan Oliver / Wennmann, Markus / Glemser, Philipp Alexander / Hielscher, Thomas / Weru, Vivienn / Görtz, Magdalena / Schütz, Viktoria / Stenzinger, Albrecht / Hohenfellner, Markus / Schlemmer, Heinz-Peter / Bonekamp, David

    European journal of radiology

    2023  Volume 165, Page(s) 110898

    Abstract: Purpose: This study aimed to assess repeatability after repositioning (inter-scan), intra-rater, inter-rater and inter-sequence variability of mean apparent diffusion coefficient (ADC) measurements in MRI-detected prostate lesions.: Method: Forty- ... ...

    Abstract Purpose: This study aimed to assess repeatability after repositioning (inter-scan), intra-rater, inter-rater and inter-sequence variability of mean apparent diffusion coefficient (ADC) measurements in MRI-detected prostate lesions.
    Method: Forty-three patients with suspicion for prostate cancer were included and received a clinical prostate bi-/multiparametric MRI examination with repeat scans of the T2-weighted and two DWI-weighted sequences (ssEPI and rsEPI). Two raters (R1 and R2) performed single-slice, 2D regions of interest (2D-ROIs) and 3D-segmentation-ROIs (3D-ROIs). Mean bias, corresponding limits of agreement (LoA), mean absolute difference, within-subject coefficient of variation (CoV) and repeatability/reproducibility coefficient (RC/RDC) were calculated. Bradley & Blackwood test was used for variance comparison. Linear mixed models (LMM) were used to account for multiple lesions per patient.
    Results: Inter-scan repeatability, intra-rater and inter-sequence reproducibility analysis of ADC showed no significant bias. 3D-ROIs demonstrated significantly less variability than 2D-ROIs (p < 0.01). Inter-rater comparison demonstrated small significant systematic bias of 57 × 10
    Conclusions: In a single-scanner setting, single-slice ADC measurements showed considerable variation, which may be lowered using 3D-ROIs. For 3D-ROIs, we propose a cut-off of ∼ 200 × 10
    MeSH term(s) Male ; Humans ; Magnetic Resonance Imaging/methods ; Prostatic Neoplasms/diagnostic imaging ; Prostatic Neoplasms/pathology ; Reproducibility of Results ; Diffusion Magnetic Resonance Imaging/methods ; Prostate/pathology
    Language English
    Publishing date 2023-06-08
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 138815-0
    ISSN 1872-7727 ; 0720-048X
    ISSN (online) 1872-7727
    ISSN 0720-048X
    DOI 10.1016/j.ejrad.2023.110898
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  7. Article ; Online: Test-retest, inter- and intra-rater reproducibility of size measurements of focal bone marrow lesions in MRI in patients with multiple myeloma.

    Wennmann, Markus / Grözinger, Martin / Weru, Vivienn / Hielscher, Thomas / Rotkopf, Lukas Thomas / Bauer, Fabian / Gnirs, Regula / Nonnenmacher, Tobias / Sauer, Sandra / Goldschmidt, Hartmut / Weinhold, Niels / Bonekamp, David / Weber, Tim Frederik / Schlemmer, Heinz-Peter / Delorme, Stefan

    The British journal of radiology

    2023  Volume 96, Issue 1145, Page(s) 20220745

    Abstract: Objective: To investigate the reproducibility of size measurements of focal bone marrow lesions (FL) in MRI in patients with monoclonal plasma cell disorders under variation of patient positioning and observer.: Methods: A data set from a prospective ...

    Abstract Objective: To investigate the reproducibility of size measurements of focal bone marrow lesions (FL) in MRI in patients with monoclonal plasma cell disorders under variation of patient positioning and observer.
    Methods: A data set from a prospective test-retest study was used, in which 37 patients with a total of 140 FL had undergone 2 MRI scans with identical parameters after patient repositioning. Two readers measured long and short axis diameter on the initial scan in
    Results: In the simple test-retest experiment with one identical reader, a deviation of ≥1 mm / ≥2 mm / ≥3 mm for the long axis diameter in
    Conclusion: Small deviations in FL size are common and probably due to variation in patient positioning or inter-rater variability alone, without any actual biological change of the FL. Knowledge of the uncertainty associated with size measurements of FLs is critical for radiologists and oncologists when interpreting changes in FL size in clinical practice and in clinical trials.
    Advances in knowledge: According to the MY-RADs criteria, size measurements of focal lesions in MRI are now of relevance for response assessment in patients with monoclonal plasma cell disorders.Size changes of 1 or 2 mm are frequently observed due to uncertainty of the measurement only, while the actual focal lesion has not undergone any biological change.Size changes of at least 6 mm or more in
    MeSH term(s) Humans ; Multiple Myeloma/diagnostic imaging ; Bone Marrow/diagnostic imaging ; Prospective Studies ; Reproducibility of Results ; Retrospective Studies ; Magnetic Resonance Imaging/methods ; Bone Diseases
    Language English
    Publishing date 2023-04-12
    Publishing country England
    Document type Journal Article
    ZDB-ID 2982-8
    ISSN 1748-880X ; 0007-1285
    ISSN (online) 1748-880X
    ISSN 0007-1285
    DOI 10.1259/bjr.20220745
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  8. Article ; Online: Whole-body magnetic resonance imaging plus serological follow-up for early identification of progression in smouldering myeloma patients to prevent development of end-organ damage.

    Wennmann, Markus / Goldschmidt, Hartmut / Mosebach, Jennifer / Hielscher, Thomas / Bäuerle, Tobias / Komljenovic, Dorde / McCarthy, Philip L / Merz, Maximilian / Schlemmer, Heinz-Peter / Raab, Marc-Steffen / Sauer, Sandra / Delorme, Stefan / Hillengass, Jens

    British journal of haematology

    2022  Volume 199, Issue 1, Page(s) 65–75

    Abstract: The definition of multiple myeloma (MM) was updated in 2014, with the intent to enable earlier treatment and thereby avoid appearance of end-organ damage at progression from smouldering multiple myeloma (SMM) to MM. The purpose of this study was to ... ...

    Abstract The definition of multiple myeloma (MM) was updated in 2014, with the intent to enable earlier treatment and thereby avoid appearance of end-organ damage at progression from smouldering multiple myeloma (SMM) to MM. The purpose of this study was to investigate to which extent the development of end-organ damage at progression to MM was reduced under the updated guidelines. In this prospective observational cohort study (ClinicalTrials.gov Identifier: NCT01374412), between 2014 and 2020, 96 SMM patients prospectively underwent whole-body magnetic resonance imaging (wb-MRI) and serological follow-up at baseline and every 6 months thereafter. A total of 22 patients progressed into MM during follow-up, of which seven (32%) showed SLiM-criteria only but no end-organ damage. Four (57%) of the seven patients who progressed by SLiM-criteria only progressed with >1 focal lesion (FL) or a growing FL, and three (43%) due to serum free light-chain-ratio ≥100. Fifteen (68%) out of 22 patients who progressed still suffered from end-organ damage at progression. The updated disease definition reduced the proportion of SMM patients suffering from end-organ damage at progression to MM by one third. wb-MRI is an important tool for detection of SMM patients who progress to MM without end-organ damage.
    MeSH term(s) Disease Progression ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Multiple Myeloma/pathology ; Prospective Studies ; Smoldering Multiple Myeloma/diagnostic imaging ; Whole Body Imaging
    Language English
    Publishing date 2022-05-24
    Publishing country England
    Document type Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 80077-6
    ISSN 1365-2141 ; 0007-1048
    ISSN (online) 1365-2141
    ISSN 0007-1048
    DOI 10.1111/bjh.18232
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  9. Article ; Online: Repeatability and Reproducibility of ADC Measurements and MRI Signal Intensity Measurements of Bone Marrow in Monoclonal Plasma Cell Disorders: A Prospective Bi-institutional Multiscanner, Multiprotocol Study.

    Wennmann, Markus / Thierjung, Heidi / Bauer, Fabian / Weru, Vivienn / Hielscher, Thomas / Grözinger, Martin / Gnirs, Regula / Sauer, Sandra / Goldschmidt, Hartmut / Weinhold, Niels / Bonekamp, David / Schlemmer, Heinz-Peter / Weber, Tim Frederik / Delorme, Stefan / Rotkopf, Lukas Thomas

    Investigative radiology

    2021  Volume 57, Issue 4, Page(s) 272–281

    Abstract: Background/objectives: Apparent diffusion coefficient (ADC) and signal intensity (SI) measurements play an increasing role in magnetic resonance imaging (MRI) of monoclonal plasma cell disorders. The purpose of this study was to assess interrater ... ...

    Abstract Background/objectives: Apparent diffusion coefficient (ADC) and signal intensity (SI) measurements play an increasing role in magnetic resonance imaging (MRI) of monoclonal plasma cell disorders. The purpose of this study was to assess interrater variability, repeatability, and reproducibility of ADC and SI measurements from bone marrow (BM) under variation of MRI protocols and scanners.
    Patients and methods: Fifty-five patients with suspected or confirmed monoclonal plasma cell disorder were prospectively included in this institutional review board-approved study and underwent several measurements after the standard clinical whole-body MR scan, including repeated scan after repositioning, scan with a second MRI protocol, scan at a second 1.5 T scanner with a harmonized MRI protocol, and scan at a 3 T scanner. For T1-weighted, T2-weighted STIR, B800 images, and ADC maps, regions of interest were placed in the BM of the iliac crest and sacral bone, and in muscle tissue for image normalization. Bland-Altman plots were constructed, and absolute bias, relative bias to mean, limits of agreement, and coefficients of variation were calculated.
    Results: Interrater variability and repeatability experiments showed a maximal relative bias of -0.077 and a maximal coefficient of variation of 16.2% for all sequences. Although the deviations at the second 1.5 T scanner with harmonized MRI protocol to the first 1.5 T scanner showed a maximal relative bias of 0.124 for all sequences, the variation of the MRI protocol and scan at the 3 T scanner led to large relative biases of up to -0.357 and -0.526, respectively. When comparing the 3 T scanner to the 1.5 T scanner, normalization to muscle reduced the bias of T1-weighted and T2-weighted sequences, but not of ADC maps.
    Conclusions: The MRI scanners with identical field strength and harmonized MRI protocols can provide relatively stable quantitative measurements of BM ADC and SI. Deviations in MRI field strength and MRI protocol should be avoided when applying ADC cutoff values, which were established at other scanners or when performing multicentric imaging trials.
    MeSH term(s) Bone Marrow/diagnostic imaging ; Diffusion Magnetic Resonance Imaging/methods ; Humans ; Magnetic Resonance Imaging ; Plasma Cells ; Prospective Studies ; Reproducibility of Results
    Language English
    Publishing date 2021-12-28
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 80345-5
    ISSN 1536-0210 ; 0020-9996
    ISSN (online) 1536-0210
    ISSN 0020-9996
    DOI 10.1097/RLI.0000000000000838
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  10. Article: Analyzing Longitudinal wb-MRI Data and Clinical Course in a Cohort of Former Smoldering Multiple Myeloma Patients: Connections between MRI Findings and Clinical Progression Patterns.

    Wennmann, Markus / Hielscher, Thomas / Kintzelé, Laurent / Menze, Bjoern H / Langs, Georg / Merz, Maximilian / Sauer, Sandra / Kauczor, Hans-Ulrich / Schlemmer, Heinz-Peter / Delorme, Stefan / Goldschmidt, Hartmut / Weinhold, Niels / Hillengass, Jens / Weber, Marc-André

    Cancers

    2021  Volume 13, Issue 5

    Abstract: The purpose of this study was to analyze size and growth dynamics of focal lesions (FL) as well as to quantify diffuse infiltration (DI) in untreated smoldering multiple myeloma (SMM) patients and correlate those MRI features with timepoint and cause of ... ...

    Abstract The purpose of this study was to analyze size and growth dynamics of focal lesions (FL) as well as to quantify diffuse infiltration (DI) in untreated smoldering multiple myeloma (SMM) patients and correlate those MRI features with timepoint and cause of progression. We investigated 199 whole-body magnetic resonance imaging (wb-MRI) scans originating from longitudinal imaging of 60 SMM patients and 39 computed tomography (CT) scans for corresponding osteolytic lesions (OL) in 17 patients. All FLs >5 mm were manually segmented to quantify volume and growth dynamics, and DI was scored, rating four compartments separately in T1- and fat-saturated T2-weighted images. The majority of patients with at least two FLs showed substantial spatial heterogeneity in growth dynamics. The volume of the largest FL (
    Language English
    Publishing date 2021-02-25
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2527080-1
    ISSN 2072-6694
    ISSN 2072-6694
    DOI 10.3390/cancers13050961
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