The Development and Pilot Testing of a New MR Imaging Protocol to Quantify Myeloma Disease Burden and Bone Loss
Condition: Myeloma; Monoclonal Gammopathy of Undetermined Significance (MGUS); Smouldering Myeloma
MeSH terms: Multiple Myeloma; Neoplasms, Plasma Cell; Smoldering Multiple Myeloma; Paraproteinemias; Monoclonal Gammopathy of Undetermined Significance
Study type: Observational

Summary: 
      In the proposed study, the investigators will aim to develop and pilot a Magnetic Resonance
      (MR) imaging protocol and assess its ability to achieve the following: quantification of
      tumour burden and bone loss, detecting longitudinal changes in tumour load with therapy and
      detecting longitudinal changes in microarchitecture with therapy. The investigators also aim
      to investigate whether bone loss is better, worse or the same with different imaging
      techniques. This will be investigated by correlating the DXA imaging data with
      Diffusion-Weighted Magnetic Resonance Imaging (DWMRI) to see if it is possible to achieve
      quantifiable data of bone density.
    

Detailed description: 
      In the proposed study, the investigators will aim to develop and pilot a Magnetic Resonance
      (MR) imaging protocol and assess its ability to achieve the following: quantification of
      tumour burden and bone loss, detecting longitudinal changes in tumour load with therapy and
      detecting longitudinal changes in microarchitecture with therapy. The investigators also aim
      to investigate whether bone loss is better, worse or the same with different imaging
      techniques. This will be investigated by correlating the DXA imaging data with
      Diffusion-Weighted Magnetic Resonance Imaging (DWMRI) to see if it is possible to achieve
      quantifiable data of bone density.

      Using the expertise of the Oxford Centre For Clinical Magnetic Resonance Research (OCMR) for
      imaging protocol development, and the new Fine Structural Analysis (FSA, Osteotronix Ltd,
      formerly Acuitas Medical) bone density quantification MRI method (Rafferty et al 2016), the
      investigators will test a single protocol which combines three emerging experimental imaging
      sequences into a simple, non-invasive whole body imaging protocol to quantify disease burden
      and bone disease. This has never been done before; if shown to be feasible, such a method
      would have two important applications: to precisely guide commissioned therapies in the
      clinic, so improving patient management; and as an exciting, novel research tool for the
      longitudinal combined assessment of tumour burden and cancer-induced bone disease in response
      to therapy.

      The investigators hypothesize that this imaging tool will be superior to the combined current
      standard-of-care investigations in the quantification of tumour burden and bone loss. There
      are currently no tools available for quantifying structural changes to bone and overall bone
      loss in myeloma.
    

Intervention name(s): Diffusion Weighted Magnetic Resonance Imaging (DWMRI); DXA scan; Bloods and urine
Intervention type(s): Other; Other; Other
Intervention description(s): Using the expertise of the Oxford Centre For Clinical Magnetic Resonance Research (OCMR) for imaging protocol development, and the new Fine Structural Analysis (FSA, Osteotronix Ltd, formerly Acuitas Medical) bone density quantification MRI method (Rafferty et al 2016), we will test a single protocol which combines three emerging experimental imaging sequences into a simple, non-invasive whole body imaging protocol to quantify disease burden and bone disease. To our knowledge, this has never been done before; if shown to be feasible, such a method would have two important applications: to precisely guide commissioned therapies in the clinic, so improving patient management; and as an exciting, novel research tool for the longitudinal combined assessment of tumour burden and cancer-induced bone disease in response to therapy.; Used to assess bone density; Samples will be taken to assess bone biomarkers
Observational model: Case-Control
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Participants in Groups 1 & 2 will be recruited via the Haematology Outpatients clinic in
        Churchill Hospital.

        Group 3 participants will be recruited from the community
      
Biospecimen description: 
      Bloods and urine