---
title: "AI-derived Whole-body MRI Metrics in Multiple Myeloma: Body Composition and Outcome Associations"
id: "pubmed-42418394"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42418394"
content_type: "clinical_feed_article"
specialty: "Oncology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42418394/"
doi: "10.1182/bloodadvances.2026020852"
published_at: "2026-09-22T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# AI-derived Whole-body MRI Metrics in Multiple Myeloma: Body Composition and Outcome Associations
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42418394
- **Specialty:** [Oncology](https://medichelpline.com/clinical-feed/oncology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42418394/)
- **DOI:** [10.1182/bloodadvances.2026020852](https://doi.org/10.1182%2Fbloodadvances.2026020852)
- **Published At:** 2026-09-22T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- Patients with **multiple myeloma** receive prolonged, multi-line, multidrug treatments that can affect overall health, physical reserve, and physiological resilience. Opportunistic analysis of routinely acquired whole-body MRI (WBMRI) can quantify body composition in nondiseased tissues. - The authors developed an **AI-based deep-learning pipeline** to perform automated organ and tissue segmentation on clinical WBMRI and produce quantitative image-derived phenotypes from nondiseased tissue in patients with myeloma. - The pipeline was applied longitudinally during treatment and identified significant temporal changes (P < .001): a decrease in **abdominal skeletal muscle (ASM)** and transient increases in abdominal subcutaneous and **visceral adipose tissue (VAT)**. - Baseline reserves of ASM (HR 0.60; 95% CI, 0.40–0.89) and abdominal subcutaneous adipose tissue (HR 0.67; 95% CI, 0.46–0.98) were associated with improved **progression-free survival (PFS)**. - Increases in **visceral adipose tissue over time** were associated with worse PFS (HR 2.89; 95% CI, 1.65–5.09). - Opportunistic body composition phenotyping from diagnostic WBMRI showed predictive value for risk stratification with a reported concordance index of 0.725. - The study reports this pipeline as a scalable biomarker for mechanistic study and clinical risk stratification in myeloma. The trial is registered as NCT02403102. - Conflict of interest: two authors (N.B. and B.W.) are cofounders of Orcino Health Ltd.; no financial relationship between Royal Marsden Hospital and Orcino Health Ltd.; other authors report no competing financial interests.
## Clinical Analysis & Structured Key Points
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more resources ](https://pubmed.ncbi.nlm.nih.gov/42418394/#linkout) Title & authors Abstract Conflict of interest statement Figures Similar articles References Publication types MeSH terms Associated data Related information LinkOut - more resources Observational Study Blood Adv Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Blood+Adv%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Blood+Adv%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42418394/) . 2026 Sep 22;10(18):6103-6111. doi: 10.1182/bloodadvances.2026020852. # AI-derived whole-body MRI metrics in patients with multiple myeloma reveal unique insights into body composition and outcomes [Nicolas Basty](https://pubmed.ncbi.nlm.nih.gov/?term=Basty+N&cauthor_id=42418394)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42418394/#full-view-affiliation-1 "The Royal Marsden NHS Foundation Trust, London, United Kingdom."), [Martin Kaiser](https://pubmed.ncbi.nlm.nih.gov/?term=Kaiser+M&cauthor_id=42418394)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42418394/#full-view-affiliation-1 "The Royal Marsden NHS Foundation Trust, London, United Kingdom.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42418394/#full-view-affiliation-2 "The Institute of Cancer Research, London, United Kingdom."), [Charlotte Pawlyn](https://pubmed.ncbi.nlm.nih.gov/?term=Pawlyn+C&cauthor_id=42418394)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42418394/#full-view-affiliation-1 "The Royal Marsden NHS Foundation Trust, London, United Kingdom.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42418394/#full-view-affiliation-2 "The Institute of Cancer Research, London, United Kingdom."), [Kevin Boyd](https://pubmed.ncbi.nlm.nih.gov/?term=Boyd+K&cauthor_id=42418394)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42418394/#full-view-affiliation-1 "The Royal Marsden NHS Foundation Trust, London, United Kingdom."), [Katy Smith](https://pubmed.ncbi.nlm.nih.gov/?term=Smith+K&cauthor_id=42418394)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42418394/#full-view-affiliation-1 "The Royal Marsden NHS Foundation Trust, London, United Kingdom."), [Karen Thomas](https://pubmed.ncbi.nlm.nih.gov/?term=Thomas+K&cauthor_id=42418394)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42418394/#full-view-affiliation-1 "The Royal Marsden NHS Foundation Trust, London, United Kingdom."), [Nuria Porta](https://pubmed.ncbi.nlm.nih.gov/?term=Porta+N&cauthor_id=42418394)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42418394/#full-view-affiliation-2 "The Institute of Cancer Research, London, United Kingdom."), [Davide Meo](https://pubmed.ncbi.nlm.nih.gov/?term=Meo+D&cauthor_id=42418394)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42418394/#full-view-affiliation-1 "The Royal Marsden NHS Foundation Trust, London, United Kingdom."), [Robby Emsley](https://pubmed.ncbi.nlm.nih.gov/?term=Emsley+R&cauthor_id=42418394)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42418394/#full-view-affiliation-1 "The Royal Marsden NHS Foundation Trust, London, United Kingdom."), [Jessica Winfield](https://pubmed.ncbi.nlm.nih.gov/?term=Winfield+J&cauthor_id=42418394)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42418394/#full-view-affiliation-1 "The Royal Marsden NHS Foundation Trust, London, United Kingdom.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42418394/#full-view-affiliation-2 "The Institute of Cancer Research, London, United Kingdom."), [Alina Dragan](https://pubmed.ncbi.nlm.nih.gov/?term=Dragan+A&cauthor_id=42418394)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42418394/#full-view-affiliation-1 "The Royal Marsden NHS Foundation Trust, London, United Kingdom."), [Simon Doran](https://pubmed.ncbi.nlm.nih.gov/?term=Doran+S&cauthor_id=42418394)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42418394/#full-view-affiliation-2 "The Institute of Cancer Research, London, United Kingdom."), [Dow-Mu Koh](https://pubmed.ncbi.nlm.nih.gov/?term=Koh+DM&cauthor_id=42418394)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42418394/#full-view-affiliation-1 "The Royal Marsden NHS Foundation Trust, London, United Kingdom.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42418394/#full-view-affiliation-2 "The Institute of Cancer Research, London, United Kingdom."), [Brandon Whitcher](https://pubmed.ncbi.nlm.nih.gov/?term=Whitcher+B&cauthor_id=42418394)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42418394/#full-view-affiliation-1 "The Royal Marsden NHS Foundation Trust, London, United Kingdom."), [Christina Messiou](https://pubmed.ncbi.nlm.nih.gov/?term=Messiou+C&cauthor_id=42418394)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42418394/#full-view-affiliation-1 "The Royal Marsden NHS Foundation Trust, London, United Kingdom.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42418394/#full-view-affiliation-2 "The Institute of Cancer Research, London, United Kingdom.") Affiliations Expand ### Affiliations * 1 The Royal Marsden NHS Foundation Trust, London, United Kingdom. * 2 The Institute of Cancer Research, London, United Kingdom. * PMID: **42418394** * PMCID: [ PMC13578971 ](https://pmc.ncbi.nlm.nih.gov/articles/PMC13578971/) * DOI: [ 10.1182/bloodadvances.2026020852 ](https://doi.org/10.1182/bloodadvances.2026020852) Item in Clipboard Observational Study # AI-derived whole-body MRI metrics in patients with multiple myeloma reveal unique insights into body composition and outcomes Nicolas Basty et al. Blood Adv. 2026. Show details Display options Display options Format Abstract PubMed PMID Blood Adv Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Blood+Adv%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Blood+Adv%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42418394/) . 2026 Sep 22;10(18):6103-6111. doi: 10.1182/bloodadvances.2026020852. ### Authors [Nicolas Basty](https://pubmed.ncbi.nlm.nih.gov/?term=Basty+N&cauthor_id=42418394)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42418394/#short-view-affiliation-1 "The Royal Marsden NHS Foundation Trust, London, United Kingdom."), [Martin Kaiser](https://pubmed.ncbi.nlm.nih.gov/?term=Kaiser+M&cauthor_id=42418394)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42418394/#short-view-affiliation-1 "The Royal Marsden NHS Foundation Trust, London, United Kingdom.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42418394/#short-view-affiliation-2 "The Institute of Cancer Research, London, United Kingdom."), [Charlotte Pawlyn](https://pubmed.ncbi.nlm.nih.gov/?term=Pawlyn+C&cauthor_id=42418394)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42418394/#short-view-affiliation-1 "The Royal Marsden NHS Foundation Trust, London, United Kingdom.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42418394/#short-view-affiliation-2 "The Institute of Cancer Research, London, United Kingdom."), [Kevin Boyd](https://pubmed.ncbi.nlm.nih.gov/?term=Boyd+K&cauthor_id=42418394)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42418394/#short-view-affiliation-1 "The Royal Marsden NHS Foundation Trust, London, United Kingdom."), [Katy Smith](https://pubmed.ncbi.nlm.nih.gov/?term=Smith+K&cauthor_id=42418394)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42418394/#short-view-affiliation-1 "The Royal Marsden NHS Foundation Trust, London, United Kingdom."), [Karen Thomas](https://pubmed.ncbi.nlm.nih.gov/?term=Thomas+K&cauthor_id=42418394)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42418394/#short-view-affiliation-1 "The Royal Marsden NHS Foundation Trust, London, United Kingdom."), [Nuria Porta](https://pubmed.ncbi.nlm.nih.gov/?term=Porta+N&cauthor_id=42418394)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42418394/#short-view-affiliation-2 "The Institute of Cancer Research, London, United Kingdom."), [Davide Meo](https://pubmed.ncbi.nlm.nih.gov/?term=Meo+D&cauthor_id=42418394)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42418394/#short-view-affiliation-1 "The Royal Marsden NHS Foundation Trust, London, United Kingdom."), [Robby Emsley](https://pubmed.ncbi.nlm.nih.gov/?term=Emsley+R&cauthor_id=42418394)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42418394/#short-view-affiliation-1 "The Royal Marsden NHS Foundation Trust, London, United Kingdom."), [Jessica Winfield](https://pubmed.ncbi.nlm.nih.gov/?term=Winfield+J&cauthor_id=42418394)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42418394/#short-view-affiliation-1 "The Royal Marsden NHS Foundation Trust, London, United Kingdom.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42418394/#short-view-affiliation-2 "The Institute of Cancer Research, London, United Kingdom."), [Alina Dragan](https://pubmed.ncbi.nlm.nih.gov/?term=Dragan+A&cauthor_id=42418394)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42418394/#short-view-affiliation-1 "The Royal Marsden NHS Foundation Trust, London, United Kingdom."), [Simon Doran](https://pubmed.ncbi.nlm.nih.gov/?term=Doran+S&cauthor_id=42418394)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42418394/#short-view-affiliation-2 "The Institute of Cancer Research, London, United Kingdom."), [Dow-Mu Koh](https://pubmed.ncbi.nlm.nih.gov/?term=Koh+DM&cauthor_id=42418394)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42418394/#short-view-affiliation-1 "The Royal Marsden NHS Foundation Trust, London, United Kingdom.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42418394/#short-view-affiliation-2 "The Institute of Cancer Research, London, United Kingdom."), [Brandon Whitcher](https://pubmed.ncbi.nlm.nih.gov/?term=Whitcher+B&cauthor_id=42418394)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42418394/#short-view-affiliation-1 "The Royal Marsden NHS Foundation Trust, London, United Kingdom."), [Christina Messiou](https://pubmed.ncbi.nlm.nih.gov/?term=Messiou+C&cauthor_id=42418394)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42418394/#short-view-affiliation-1 "The Royal Marsden NHS Foundation Trust, London, United Kingdom.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42418394/#short-view-affiliation-2 "The Institute of Cancer Research, London, United Kingdom.") ### Affiliations * 1 The Royal Marsden NHS Foundation Trust, London, United Kingdom. * 2 The Institute of Cancer Research, London, United Kingdom. * PMID: **42418394** * PMCID: [ PMC13578971 ](https://pmc.ncbi.nlm.nih.gov/articles/PMC13578971/) * DOI: [ 10.1182/bloodadvances.2026020852 ](https://doi.org/10.1182/bloodadvances.2026020852) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID ## Abstract Patients with multiple myeloma are frequently exposed to prolonged, multiline and multidrug treatments, factors that may substantially influence overall health, physical reserve, and physiological resilience. Imaging of organs that are captured by whole-body scans can be opportunistically interrogated to derive direct, quantitative measures of body composition. Advances and standardization of whole-body magnetic resonance imaging (WBMRI) together with recent improvements in artificial intelligence (AI) methodologies for automated organ and tissue segmentation presents an opportunity to complement accurate disease assessments with body composition metrics. We report, to our knowledge, for the first time, development of an AI-based pipeline to enable automated quantitative image-derived phenotypes in nondiseased tissue from WBMRI in patients with multiple myeloma. We have demonstrated that a deep-learning pipeline can derive body composition metrics from routinely acquired clinical WBMRI. Throughout treatment, significant longitudinal changes were observed (P< .001), characterized by a decrease in abdominal skeletal muscle (ASM) alongside transient increases in abdominal subcutaneous and visceral adipose tissue. We have also shown that greater reserves of ASM (hazard ratio [HR], 0.60; 95% confidence interval [CI], 0.40-0.89) and abdominal subcutaneous adipose tissue (HR, 0.67; 95% CI, 0.46-0.98) at baseline are associated with better progression-free survival. Conversely increases in visceral adipose tissue over time was associated with inferior progression-free survival (HR, 2.89; 95% CI, 1.65-5.09). These findings support opportunistic body composition phenotyping from diagnostic WBMRI as a scalable biomarker for risk stratification (concordance index, 0.725) and mechanistic study. This trial was registered at www.clinicaltrials.gov as [NCT02403102](http://clinicaltrials.gov/show/NCT02403102 "See in ClinicalTrials.gov"). © 2026 American Society of Hematology. Published by Elsevier Inc. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0), permitting only noncommercial, nonderivative use with attribution. All other rights reserved. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement Conflict-of-interest disclosure: N.B. and B.W. are cofounders of Orcino Health Ltd. There is no financial relationship between the Royal Marsden Hospital and Orcino Health Ltd. The remaining authors declare no competing financial interests. ## Figures [ ![None](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c90b/13578971/2b5bb09b3167/BLOODA_ADV-2026-020852-ga1.gif) ](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c90b/13578971/0e2193596e83/BLOODA_ADV-2026-020852-ga1.webp) ** Graphical abstract ** ** Graphical abstract ** **Graphical abstract** [ ![Figure 1.](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c90b/13578971/3fcc19603aba/BLOODA_ADV-2026-020852-gr1.gif) ](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c90b/13578971/7cf17588d524/BLOODA_ADV-2026-020852-gr1.webp) ** Figure 1. ** **Schematic of pipeline input (WBMRI)…** ** Figure 1. ** **Schematic of pipeline input (WBMRI) and output (3D segmentations).** The pipeline takes WBMRI… **Figure 1.** **Schematic of pipelin
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