{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T09:45:24Z","timestamp":1761731124558,"version":"build-2065373602"},"reference-count":39,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T00:00:00Z","timestamp":1761523200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Whole-body magnetic resonance imaging (WB-MRI) is incorporated into international guidelines and recommendations for imaging patients with multiple myeloma. The aim of this study was to investigate inter-observer agreement of radiologists with different levels of expertise in reporting whole-body MRI performed along MY-RADS criteria in myeloma at baseline and in evaluating response to therapy to better certify the use of these criteria. Methods: A total of 52 patients with symptomatic myeloma at first presentation (47) or relapse (5) and planned for a new line of therapy were included. All patients completed baseline whole-body MRI within 1 month prior to starting treatment. A total of 25 patients were evaluated with WB-MRI within 1 month after therapy. Each scan was reported independently by three radiologists using MY-RADS. Differences in observer scores were compared using analysis of variance (ANOVA), and inter-observer agreement was assessed using the intra-class correlation coefficient (ICC). Results: Interobserver agreement was excellent for all anatomic regions (&gt; 0.81), both at baseline and at follow-up. Quantitative MRI analysis demonstrated that there was no significant difference in mean observer scores for the whole skeleton, and ICC demonstrated excellent inter-observer agreement at 0.9197 for ROI dimension, 0.94 for ADC values, and 0.98 for rFF%. Conclusion: MY RADS has excellent inter-observer agreement in reporting symptomatic myeloma at baseline and follow-up after therapy. In our study, there was no discrepancy between skeletal regions, highlighting specific areas of difficulty.<\/jats:p>","DOI":"10.3390\/diagnostics15212715","type":"journal-article","created":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T13:59:36Z","timestamp":1761659976000},"page":"2715","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Qualitative and Quantitative Inter-Observer Agreement of Multiparametric Whole-Body MRI in Staging and Follow-Up of Myeloma Patients"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9126-9229","authenticated-orcid":false,"given":"Alice","family":"Rossi","sequence":"first","affiliation":[{"name":"Radiology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) \u201cDino Amadori\u201d, 47014 Meldola, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9574-586X","authenticated-orcid":false,"given":"Arrigo","family":"Cattabriga","sequence":"additional","affiliation":[{"name":"Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"},{"name":"Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0836-9473","authenticated-orcid":false,"given":"Andrea","family":"Prochowski Iamurri","sequence":"additional","affiliation":[{"name":"Radiology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) \u201cDino Amadori\u201d, 47014 Meldola, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eleonora","family":"Antognoni","sequence":"additional","affiliation":[{"name":"School of Specialization in Radiology, University of Ferrara, 44121 Ferrara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5808-7044","authenticated-orcid":false,"given":"Irene","family":"Azzali","sequence":"additional","affiliation":[{"name":"Unit of Biostatistics and Clinical Trials, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) \u201cDino Amadori\u201d, 47014 Meldola, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4429-3971","authenticated-orcid":false,"given":"Giacomo","family":"Feliciani","sequence":"additional","affiliation":[{"name":"Medical Physics Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) \u201cDino Amadori\u201d, 47014 Meldola, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9104-5436","authenticated-orcid":false,"given":"Claudio","family":"Cerchione","sequence":"additional","affiliation":[{"name":"Hematology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) \u201cDino Amadori\u201d, 47014 Meldola, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilaria","family":"Bronico","sequence":"additional","affiliation":[{"name":"Radiology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) \u201cDino Amadori\u201d, 47014 Meldola, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danila","family":"Diano","sequence":"additional","affiliation":[{"name":"Radiology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) \u201cDino Amadori\u201d, 47014 Meldola, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6822-9053","authenticated-orcid":false,"given":"Cristina","family":"Mosconi","sequence":"additional","affiliation":[{"name":"Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"},{"name":"Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1802","DOI":"10.1002\/ajh.27422","article-title":"Multiple Myeloma: 2024 Update on Diagnosis, Risk-Stratification, and Management","volume":"99","author":"Rajkumar","year":"2024","journal-title":"Am. J. Hematol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e328","DOI":"10.1016\/S1470-2045(16)30206-6","article-title":"International Myeloma Working Group Consensus Criteria for Response and Minimal Residual Disease Assessment in Multiple Myeloma","volume":"17","author":"Kumar","year":"2016","journal-title":"Lancet Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1182\/blood-2018-08-825356","article-title":"Imaging in Multiple Myeloma: How? When?","volume":"133","author":"Zamagni","year":"2019","journal-title":"Blood"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e302","DOI":"10.1016\/S1470-2045(19)30309-2","article-title":"International Myeloma Working Group Consensus Recommendations on Imaging in Monoclonal Plasma Cell Disorders","volume":"20","author":"Hillengass","year":"2019","journal-title":"Lancet Oncol."},{"key":"ref_5","first-page":"479","article-title":"Application of 18F-FDG PET and Diffusion Weighted Imaging (DWI) in Multiple Myeloma: Comparison of Functional Imaging Modalities","volume":"5","author":"Sachpekidis","year":"2015","journal-title":"Am. J. Nucl. Med. Mol. Imaging"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1007\/s00256-021-03841-5","article-title":"Imaging of Treatment Response and Minimal Residual Disease in Multiple Myeloma: State of the Art WB-MRI and PET\/CT","volume":"51","author":"Lecouvet","year":"2022","journal-title":"Skeletal Radiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1002\/ajh.23258","article-title":"Diffuse Pattern of Bone Marrow Involvement on Magnetic Resonance Imaging Is Associated with High Risk Cytogenetics and Poor Outcome in Newly Diagnosed, Symptomatic Patients with Multiple Myeloma: A Single Center Experience on 228 Patients","volume":"87","author":"Moulopoulos","year":"2012","journal-title":"Am. J. Hematol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e210048","DOI":"10.1148\/rycan.2021210048","article-title":"Prospective Evaluation of Whole-Body MRI versus FDG PET\/CT for Lesion Detection in Participants with Myeloma","volume":"3","author":"Messiou","year":"2021","journal-title":"Radiol. Imaging Cancer"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"602","DOI":"10.2214\/AJR.21.26381","article-title":"Comparative Performance of Whole-Body MRI and FDG PET\/CT in Evaluation of Multiple Myeloma Treatment Response: Systematic Review and Meta-Analysis","volume":"218","author":"Rama","year":"2022","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2558","DOI":"10.1007\/s00259-020-05182-2","article-title":"Comparison of the Diagnostic Performance and Impact on Management of 18F-FDG PET\/CT and Whole-Body MRI in Multiple Myeloma","volume":"48","author":"Westerland","year":"2021","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1097\/RLU.0000000000006048","article-title":"Comparison of MRI, [18F]FDG-PET\/CT, and [18F]FDG-PET\/MRI for Initial Staging of Multiple Myeloma: A Systematic Review and Meta-Analysis","volume":"50","author":"Tordjman","year":"2025","journal-title":"Clin. Nucl. Med."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Filippi, L., Frantellizzi, V., Bartoletti, P., De Vincentis, G., Schillaci, O., and Evangelista, L. (2023). Head-to-Head Comparison between FDG and 11C-Methionine in Multiple Myeloma: A Systematic Review. Diagnostics, 13.","DOI":"10.3390\/diagnostics13122009"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1148\/radiol.2019181949","article-title":"Guidelines for Acquisition, Interpretation, and Reporting of Whole-Body MRI in Myeloma: Myeloma Response Assessment and Diagnosis System (MY-RADS)","volume":"291","author":"Messiou","year":"2019","journal-title":"Radiology"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1815","DOI":"10.1007\/s00256-024-04723-2","article-title":"Present and Future of Whole-Body MRI in Metastatic Disease and Myeloma: How and Why You Will Do It","volume":"53","author":"Lecouvet","year":"2024","journal-title":"Skeletal Radiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1016\/j.eururo.2024.02.016","article-title":"Whole-Body Magnetic Resonance Imaging as a Treatment Response Biomarker in Castration-Resistant Prostate Cancer with Bone Metastases: The IPROMET Clinical Trial","volume":"86","author":"Macarro","year":"2024","journal-title":"Eur. Urol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2890","DOI":"10.1007\/s00330-018-5330-5","article-title":"ADC as a Useful Diagnostic Tool for Differentiating Benign and Malignant Vertebral Bone Marrow Lesions and Compression Fractures: A Systematic Review and Meta-Analysis","volume":"28","author":"Suh","year":"2018","journal-title":"Eur. Radiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"4514","DOI":"10.1007\/s00330-020-07522-0","article-title":"Repeatability and Reproducibility of ADC Measurements: A Prospective Multicenter Whole-Body-MRI Study","volume":"31","author":"Michoux","year":"2021","journal-title":"Eur. Radiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"20230240","DOI":"10.1259\/bjr.20230240","article-title":"Relative Fat Fraction of Malignant Bone Lesions from Breast Cancer, Prostate Cancer and Myeloma Are Significantly Lower than Normal Bone Marrow and Shows Excellent Interobserver Agreement","volume":"96","author":"Castagnoli","year":"2023","journal-title":"Br. J. Radiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"4647","DOI":"10.1007\/s00330-022-08536-6","article-title":"Multiparametric Bone MRI Can Improve CT-Guided Bone Biopsy Target Selection in Cancer Patients and Increase Diagnostic Yield and Feasibility of next-Generation Tumour Sequencing","volume":"32","author":"Donners","year":"2022","journal-title":"Eur. Radiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1148\/radiol.211388","article-title":"Comparison of MRI Features of Fat Fraction and ADC for Early Treatment Response Assessment in Participants with Multiple Myeloma","volume":"304","author":"Koutoulidis","year":"2022","journal-title":"Radiology"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1007\/s11547-020-01258-z","article-title":"Quantitative Bone Marrow Magnetic Resonance Imaging Through Apparent Diffusion Coefficient and Fat Fraction in Multiple Myeloma Patients","volume":"126","author":"Berardo","year":"2021","journal-title":"Radiol. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1186\/s40644-020-00328-9","article-title":"Inter-Observer Agreement of Baseline Whole Body MRI in Multiple Myeloma","volume":"20","author":"Croft","year":"2020","journal-title":"Cancer Imaging"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1148\/radiol.13131529","article-title":"Whole-Body Diffusion-Weighted MR Imaging for Assessment of Treatment Response in Myeloma","volume":"271","author":"Giles","year":"2014","journal-title":"Radiology"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Feliciani, G., Loi, E., Amadori, E., Antognoni, E., Iamurri, A.P., Diano, D., Bruno, D., Cattabriga, A., Caroli, P., and Marchesini, M. (Haematologica, 2025). Radiopsy: A Prospective Observational Study on Quantitative Multiparametric Whole-Body Magnetic Resonance Imaging to Discriminate between Smoldering and Multiple Myeloma, Haematologica, in press.","DOI":"10.3324\/haematol.2025.287563"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e233055","DOI":"10.1148\/radiol.233055","article-title":"The QIBA Profile for Diffusion-Weighted MRI: Apparent Diffusion Coefficient as a Quantitative Imaging Biomarker","volume":"313","author":"Boss","year":"2024","journal-title":"Radiology"},{"key":"ref_26","unstructured":"(2025, April 10). QIBA Profile: Magnetic Resonance Diffusion-Weighted Imaging (DWI) of the Apparent Diffusion Coefficient (ADC). Available online: https:\/\/qibawiki.rsna.org\/images\/b\/b0\/QIBA_DWIProfile_Stage3_15Dec2022_v3.pdf."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e538","DOI":"10.1016\/S1470-2045(14)70442-5","article-title":"International Myeloma Working Group Updated Criteria for the Diagnosis of Multiple Myeloma","volume":"15","author":"Rajkumar","year":"2014","journal-title":"Lancet Oncol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1186\/s40644-020-00350-x","article-title":"Whole-Body Magnetic Resonance Imaging (WB-MRI) Reporting with the METastasis Reporting and Data System for Prostate Cancer (MET-RADS-P): Inter-Observer Agreement Between Readers of Different Expertise Levels","volume":"20","author":"Pricolo","year":"2020","journal-title":"Cancer Imaging"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1007\/s00330-019-06281-x","article-title":"Interobserver Agreement of Whole-Body Magnetic Resonance Imaging Is Superior to Whole-Body Computed Tomography for Assessing Disease Burden in Patients with Multiple Myeloma","volume":"30","author":"Lai","year":"2020","journal-title":"Eur. Radiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1927","DOI":"10.1007\/s00330-019-06469-1","article-title":"MRI versus 18F-FDG-PET\/CT for Detecting Bone Marrow Involvement in Multiple Myeloma: Diagnostic Performance and Clinical Relevance","volume":"30","author":"Lecouvet","year":"2020","journal-title":"Eur. Radiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1007\/s11547-021-01391-3","article-title":"Learning Curves in Radiological Reporting of Whole-Body MRI in Plasma Cell Disease: A Retrospective Study","volume":"126","author":"Negroni","year":"2021","journal-title":"Radiol. Med."},{"key":"ref_32","unstructured":"(2025, May 12). MRI-Based Proton Density Fat Fraction (PDFF) of the Liver. Available online: https:\/\/qibawiki.rsna.org\/images\/6\/63\/MRI-Based_PDFF_of_the_Liver_QIBA_Profile_2024_06-19_CONSENSUS-maintenance.pdf."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1762","DOI":"10.1002\/jmri.26748","article-title":"Proton Density Fat Fraction MRI of Vertebral Bone Marrow: Accuracy, Repeatability, and Reproducibility among Readers, Field Strengths, and Imaging Platforms","volume":"50","author":"Schmeel","year":"2019","journal-title":"J. Magn. Reson. Imaging"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.eururo.2016.05.033","article-title":"METastasis Reporting and Data System for Prostate Cancer: Practical Guidelines for Acquisition, Interpretation, and Reporting of Whole-Body Magnetic Resonance Imaging-Based Evaluations of Multiorgan Involvement in Advanced Prostate Cancer","volume":"71","author":"Padhani","year":"2017","journal-title":"Eur. Urol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"20230378","DOI":"10.1259\/bjr.20230378","article-title":"Repeatability of Quantitative Individual Lesion and Total Disease Multiparametric Whole-Body MRI Measurements in Prostate Cancer Bone Metastases","volume":"96","author":"Donners","year":"2023","journal-title":"Br. J. Radiol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1007\/s00062-021-01009-1","article-title":"Diagnostic Accuracy of Quantitative Imaging Biomarkers in the Differentiation of Benign and Malignant Vertebral Lesions: Combination of Diffusion-Weighted and Proton Density Fat Fraction Spine MRI","volume":"31","author":"Schmeel","year":"2021","journal-title":"Clin. Neuroradiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1186\/s13244-023-01498-3","article-title":"Image Quality in Whole-Body MRI Using the MY-RADS Protocol in a Prospective Multi-Centre Multiple Myeloma Study","volume":"14","author":"Keaveney","year":"2023","journal-title":"Insights Imaging"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1186\/s13244-022-01253-0","article-title":"Implementation of Whole-Body MRI (MY-RADS) within the OPTIMUM\/MUKnine Multi-Centre Clinical Trial for Patients with Myeloma","volume":"13","author":"Rata","year":"2022","journal-title":"Insights Imaging"},{"key":"ref_39","first-page":"20200004","article-title":"Repeatability and Reproducibility of MRI Apparent Diffusion Coefficient Applied on Four Different Regions of Interest for Patients with Axial Spondyloarthritis and Healthy Volunteers Scanned Twice within a Week","volume":"2","author":"Thomsen","year":"2020","journal-title":"BJR Open"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/21\/2715\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T02:47:13Z","timestamp":1761706033000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/21\/2715"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,27]]},"references-count":39,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["diagnostics15212715"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics15212715","relation":{},"ISSN":["2075-4418"],"issn-type":[{"type":"electronic","value":"2075-4418"}],"subject":[],"published":{"date-parts":[[2025,10,27]]}}}