Abstract
Simple SummaryWhole-body magnetic resonance imaging (MRI) is recognized as the most sensitive imaging technique for the detection of bone marrow infiltration, and was therefore, recently included in the new diagnostic myeloma criteria, as proposed by the International Myeloma Working Group. The use of diffusion-weighted MRI further improved the performances of whole-body MRI in the setting of multiple myeloma, and its systematic implementation in general clinical practice is now recommended. Whole-body, dynamic, contrast-enhanced MRI might provide further information on lesions vascularity and might help evaluate response to treatment. Hybrid PET/MRI might act as the optimal imaging modality, owing to the association of the best techniques for both detecting bone marrow involvement and evaluating treatment response, providing one-stop-shop imaging in a whole-body scale. This review provides an overview on the value of whole-body MRI, including diffusion-weighted and dynamic contrast-enhanced MRI and whole-body 18F-FDG PET/MRI in diagnosis, staging, and response evaluation in multiple myeloma.Bone disease is one of the major features of multiple myeloma (MM), and imaging has a pivotal role in both diagnosis and follow-up. Whole-body magnetic resonance imaging (MRI) is recognized as the gold standard for the detection of bone marrow involvement, owing to its high sensitivity. The use of functional MRI sequences further improved the performances of whole-body MRI in the setting of MM. Whole-body diffusion-weighted (DW) MRI is the most attractive functional technique and its systematic implementation in general clinical practice is now recommended by the International Myeloma Working Group. Whole-body dynamic contrast-enhanced (DCE) MRI might provide further information on lesions vascularity and help evaluate response to treatment. Whole Body PET/MRI is an emerging hybrid imaging technique that offers the opportunity to combine information on morphology, fat content of bone marrow, bone marrow cellularity and vascularization, and metabolic activity. Whole-body PET/MRI allows a one-stop-shop examination, including the most sensitive technique for detecting bone marrow involvement, and the most recognized technique for treatment response evaluation. This review aims at providing an overview on the value of whole-body MRI, including DW and DCE MRI, and combined whole-body 18F-FDG PET/MRI in diagnosis, staging, and response evaluation in patients with MM.
Highlights
Multiple myeloma (MM) is a hematological disorder characterized by the proliferation of plasma cells producing abnormal monoclonal immunoglobulin and infiltrating bone marrow [1]
The use of functional magnetic resonance imaging (MRI) sequences further improved the performances of whole-body MRI in the setting of MM
Whole-body dynamic contrast-enhanced (DCE) MRI might provide further information on lesions vascularity and help evaluate response to treatment [6]. This increasingly important role of whole-body MRI has led to the design of Myeloma Response Assessment and Diagnosis
Summary
Multiple myeloma (MM) is a hematological disorder characterized by the proliferation of plasma cells producing abnormal monoclonal immunoglobulin and infiltrating bone marrow [1]. Whole-body MRI is the most sensitive technique for the detection of bone marrow involvement and allows the detection of both diffuse bone marrow infiltration and focal lesions, before the mineral bone is destroyed [2] This has led the International Myeloma Working Group to recommend whole-body MRI as first-line imaging for all patients with a suspected diagnosis of asymptomatic myeloma or solitary bone plasmacytoma [3]. Whole-body dynamic contrast-enhanced (DCE) MRI might provide further information on lesions vascularity and help evaluate response to treatment [6] This increasingly important role of whole-body MRI has led to the design of Myeloma Response Assessment and Diagnosis. MRI and DW MRI, and combined whole-body 18 F-FDG PET/MRI in diagnosis, staging, and response evaluation in patients with MM
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