Use of whole-body diffusion-weighted magnetic resonance imaging for the diagnosis of and therapeutic response in multiple myeloma

Abstract

Multiple myeloma is an incurable neoplastic disorder of B cells characterized by diffuse bone marrow infiltration, circumscribed bone lesions, and soft-tissue spreading. The role of novel functional imaging techniques in multiple myeloma includes initial staging of the disease, detection and characterization of complications, and evaluation of the response to treatment. The authors present their 2 and a half-year experience with diffusion-weighted magnetic resonance imaging in staging and follow up of patients with multiple myeloma. Conventional T1 weighted, T2 weighted fat suppressed and 2 b-values diffusion-weighted sequences were performed from skull base to symphysis in 27 patients suspected to have multiple myeloma. Apparent diffusion coefficient calculation was carried out in 3 cases. The final diagnosis of multiple myeloma was verified by bone-marrow biopsy. In 13 cases magnetic resonance imaging revealed the suspected disease. In one patient magnetic resonance imaging failed to detect the disease because of metallic artifacts. In 6 cases diffusion-weighted sequences showed additional information about bone-marrow infiltration. Diffusion-weighted magnetic resonance imaging with conventional sequences is a useful and promising functional imaging modality in the early diagnosis of myeloma multiple.