{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T05:33:56Z","timestamp":1788845636163,"version":"build-2803163510"},"reference-count":32,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2023,8,7]],"date-time":"2023-08-07T00:00:00Z","timestamp":1691366400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Interdisciplinary Center of Clinical Research W\u00fcrzburg","award":["Z-3BC\/02"],"award-info":[{"award-number":["Z-3BC\/02"]}]},{"name":"Interdisciplinary Center of Clinical Research W\u00fcrzburg","award":["JU 426\/10-1 (F.J., 491715122)"],"award-info":[{"award-number":["JU 426\/10-1 (F.J., 491715122)"]}]},{"name":"Interdisciplinary Center of Clinical Research W\u00fcrzburg","award":["JU 426\/11-1 (F.J., 496963451)"],"award-info":[{"award-number":["JU 426\/11-1 (F.J., 496963451)"]}]},{"name":"German Research Foundation (DFG)","award":["Z-3BC\/02"],"award-info":[{"award-number":["Z-3BC\/02"]}]},{"name":"German Research Foundation (DFG)","award":["JU 426\/10-1 (F.J., 491715122)"],"award-info":[{"award-number":["JU 426\/10-1 (F.J., 491715122)"]}]},{"name":"German Research Foundation (DFG)","award":["JU 426\/11-1 (F.J., 496963451)"],"award-info":[{"award-number":["JU 426\/11-1 (F.J., 496963451)"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Multiple myeloma (MM) frequently induces persisting osteolytic manifestations despite hematologic treatment response. This study aimed to establish a biometrically valid study endpoint for bone remineralization through quantitative and qualitative analyses in sequential CT scans. Twenty patients (seven women, 58 \u00b1 8 years) with newly diagnosed MM received standardized induction therapy comprising the anti-SLAMF7 antibody elotuzumab, carfilzomib, lenalidomide, and dexamethasone (E-KRd). All patients underwent whole-body low-dose CT scans before and after six cycles of E-KRd. Two radiologists independently recorded osteolytic lesion sizes, as well as the presence of cortical destruction, pathologic fractures, rim and trabecular sclerosis. Bland\u2013Altman analyses and Krippendorff\u2019s \u03b1 were employed to assess inter-reader reliability, which was high for lesion size measurement (standard error 1.2 mm) and all qualitative criteria assessed (\u03b1 \u2265 0.74). After six cycles of E-KRd induction, osteolytic lesion size decreased by 22% (p &lt; 0.001). While lesion size response did not correlate with the initial lesion size at baseline imaging (Pearson\u2019s r = 0.144), logistic regression analysis revealed that the majority of responding osteolyses exhibited trabecular sclerosis (p &lt; 0.001). The sum of osteolytic lesion sizes on sequential CT scans defines a reliable study endpoint to characterize bone remineralization. Patient level response is strongly associated with the presence of trabecular sclerosis.<\/jats:p>","DOI":"10.3390\/cancers15154008","type":"journal-article","created":{"date-parts":[[2023,8,7]],"date-time":"2023-08-07T06:38:48Z","timestamp":1691390328000},"page":"4008","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Assessing Osteolytic Lesion Size on Sequential CT Scans Is a Reliable Study Endpoint for Bone Remineralization in Newly Diagnosed Multiple Myeloma"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4524-1620","authenticated-orcid":false,"given":"Jan-Peter","family":"Grunz","sequence":"first","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, University Hospital W\u00fcrzburg, Oberd\u00fcrrbacher Stra\u00dfe 6, 97080 W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8429-2992","authenticated-orcid":false,"given":"Andreas Steven","family":"Kunz","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, University Hospital W\u00fcrzburg, Oberd\u00fcrrbacher Stra\u00dfe 6, 97080 W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Freerk T.","family":"Baumann","sequence":"additional","affiliation":[{"name":"Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University Hospital of Cologne, Kerpener Stra\u00dfe 62, 50937 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"Hasenclever","sequence":"additional","affiliation":[{"name":"Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, H\u00e4rtelstra\u00dfe 16\u201318, 04107 Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malte Maria","family":"Sieren","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Ratzeburger Allee 160, 23562 L\u00fcbeck, Germany"},{"name":"Institute of Interventional Radiology, University Hospital Schleswig-Holstein, Ratzeburger Allee 160, 23562 L\u00fcbeck, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9206-2086","authenticated-orcid":false,"given":"Stefan","family":"Heldmann","sequence":"additional","affiliation":[{"name":"Fraunhofer Institute for Digital Medicine MEVIS, Maria-Goeppert-Stra\u00dfe 3, 23562 L\u00fcbeck, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thorsten Alexander","family":"Bley","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, University Hospital W\u00fcrzburg, Oberd\u00fcrrbacher Stra\u00dfe 6, 97080 W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7680-0819","authenticated-orcid":false,"given":"Hermann","family":"Einsele","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II, University Hospital W\u00fcrzburg, Oberd\u00fcrrbacher Stra\u00dfe 6, 97080 W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Knop","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II, University Hospital W\u00fcrzburg, Oberd\u00fcrrbacher Stra\u00dfe 6, 97080 W\u00fcrzburg, Germany"},{"name":"Department of Internal Medicine, Klinikum N\u00fcrnberg Nord, Prof.-Ernst-Nathan-Str. 1, 90419 N\u00fcrnberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8661-7110","authenticated-orcid":false,"given":"Franziska","family":"Jundt","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II, University Hospital W\u00fcrzburg, Oberd\u00fcrrbacher Stra\u00dfe 6, 97080 W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2197","DOI":"10.1016\/S0140-6736(14)60493-1","article-title":"Multiple myeloma","volume":"385","author":"Knop","year":"2015","journal-title":"Lancet"},{"key":"ref_2","unstructured":"(2023, July 27). 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