The aim of our study was to compare, in Whole Body-MRI (WB-MRI),the diagnostic capabilities of apparent diffusion coefficient (ADC) maps and dynamic contrast enhanced (DCE-MRI) in evaluation of post treatment response of Multiple Myeloma (MM).

The retrospective study includes forty-five patients affected by MM, all underwent radio/chemotherapy or autologous stem cell transplant. The protocol included coronal WB and sagittal (axial skeleton) TSE T1 ,STIR T2 and axial DWIBS (b: 0-600 mm2/sec) sequences. Imaging post-contrast was performed immediately after injection during the first5 min. Mean ADC values of focal suspected lesions and diffuse localizations were calculated (fig. 1, 2). DCE-MRI images of the spine were obtained by volumetric T1 SPIR, sagittal or coronal planes, on the basis of the lesions localizations....

DWI sensibility in detection disease remission was 88%, specificity 71%; in the relapse cases,(were considered positive the mean ADC values: 0.8±0.21x10-3 mm²/sec in focal lesions, 0.5±0.22x10-3 mm²/sec in diffuse involvement) sensitivity was 94%, specificity was 88%.DCE-MRI showed, in remission of disease,74% of sensitivity and 93% of specificity. In relapse of disease DCE-MRI showed 74% of sensitivity and 93% of specificity (FIG. 3-6). In some patients (9%), progressive disease was detected earlier by WB-DW-MRI than by the routine biochemical follow-up.

DCE-MRI approach showed greater specificity in the evaluation of both remission and relapse of disease. WB-DWI-MR increase detection of relapse of disease in myeloma patients in comparison to DCE-MRI. A combined evaluation of DWI and DCE-MRI provides a comprehensive assessment of post treatment response in Multiple Myeloma.

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