Effects of imaging variables on OS, PFS, and CRD in Total Therapy 3A and Total Therapy 3B combined. (A) Baseline number of MBS-defined osteolytic lesions (OL). Superior OS and PFS were linked to the presence of no more than 2 OL. A trend was noted in case of complete response duration. (B) Baseline number of MRI-defined FL and diffuse hyperintense marrow. Trends were observed for superior OS and PFS in case of MRI-FL not exceeding 7 FL. (C) Baseline PET-defined number of FL.The presence of more than 3 PET-defined FL affected all 3 survival end points adversely. (D) Baseline PET-defined SUVmax. Higher SUVmax of PET-defined FL conferred inferior OS, PFS, and complete response (CR) duration. (E) Day 7 PET-FL. OS and PFS were inferior when more than 3 FL persisted on day 7 after starting protocol therapy. In case of CR duration, a strong trend in the same direction was noted. (F) Pretransplant MRI-FL. Trends were observed for both OS and PFS with the best survival at 3 years observed in those with 0 MRI FL, followed by 1 to 7 MRI FL and >7 MRI FL. Similar to the baseline results, survival at 3 years for those with DHIM was more like patients with 1 to 7 or >7 MRI FL. (G) Pretransplant PET-FL. A graded negative impact was observed with increasing PET-defined FL remaining before first transplant.