Abstract
The aim of the study is to evaluate the effectiveness of short whole-body magnetic resonance imaging (WBMRI) protocols for the overall assessment of bone marrow involvement in patients with multiple myeloma (MM), in comparison with standard whole-body MRI protocol. Patients with biopsy-proven MM, who underwent a WBMRI with full-body coverage (from vertex to feet) were retrospectively enrolled. WBMRI images were independently evaluated by two expert radiologists, in terms of infiltration patterns (normal, focal, diffuse, and combined), according to location (the whole skeleton was divided into six anatomic districts: skull, spine, sternum and ribs, upper limbs, pelvis and proximal two-thirds of the femur, remaining parts of lower limbs) and lytic lesions number (<5, 5–20, and >20). The majority of patients showed focal and combined infiltration patterns with bone lesions predominantly distributed in the spine and pelvis. As skull and lower limbs are less frequently involved by focal bone lesions, excluding them from the standard MRI protocol allows to obtain a shorter protocol, maintaining a good diagnostic value.
Highlights
Multiple myeloma (MM) is a plasma cell dyscrasia, characterized by proliferation and accumulation of monoclonal plasma cells [1]
The aim of the study is to evaluate the effectiveness of short whole-body magnetic resonance imaging (WBMRI) protocols for the overall assessment of bone marrow involvement in patients with multiple myeloma (MM), in comparison with standard whole-body MRI protocol
Whole-body MRI (WBMRI) images were independently evaluated by two expert radiologists, in terms of infiltration patterns, according to location and lytic lesions number (20)
Summary
Multiple myeloma (MM) is a plasma cell dyscrasia, characterized by proliferation and accumulation of monoclonal plasma cells [1]. A careful evaluation of the degree of skeletal involvement is of utmost importance in all patients suspected of MM, such as those with CRAB features (hypercalcemia, renal failure, anemia, and bone disease) or smoldering MM [2], as proposed by the revised International Myeloma Working Group (IMWG) criteria for the diagnosis of MM [2]. In this context, whole-body (WB) imaging techniques, such as computed tomography (CT) and fluorodeoxyglucose positron emission tomography (FDG-PET) acquired increased importance over the past few years. Whole-body MRI (WBMRI) is the procedure of choice for evaluating painful complications and spinal cord compression in MM and the best noninvasive technique for differentiating neoplastic from osteoporotic vertebral fractures [7]
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