Purpose
Whole-body MRI is a promising technique for distinguishing bone marrow infiltration among patients with multiple myeloma, even in the early stages of the disease [1].
There are 5 types of patterns of bone marrow infiltration, which we can distinguish with help of MRI: normal, focal, diffuse, combined diffuse and focal and variegated. Normal bone marrow presents a hyperintense signal compared to intervertebral disks on T1-weighted images and a hypointense signal compared to paravertebral muscle tissue on short TI inversion recovery (STIR) images [2,3]. Focal lesions...
Methods and materials
Patient population:14 patients (5 M/9 F, median age 55 years; range: 33-71 years) with newly diagnosed, untreated multiple myeloma, plasmacytoma, and plasmablastic lymphoma were included in the study between January 2019 and October 2019. 12 patients had multiple myeloma, 1 patient had plasmacytoma and 1 patient had plasmablastic lymphoma.
Data acquisition:Whole-body MRI with DWIBS imaging was conducted on a 1.5 T scanner (Ingenia, Philips, Netherlands). Patients were placed in a spine position. The whole-body MRI protocol included DWIBS with 3 b-values (0, 500, 1000 s/mm²),...
Results
mean ADC value were 0,84±0,06*10¯³mm²/s (range:0,8-0,98*10¯3 mm²/s) for focal pattern, 0,62±0,03*10¯³mm²/s (range:0,6-0,67*10¯3mm²/s) for diffuse and variegated patterns. Analysis using the t-test showed significant differences in ADC values (p=0,0005) between focal, both diffuse and variegated patterns of infiltration. There weren’t differences in ADC values between patients with multiple myeloma, plasmacytoma, and plasmablastic lymphoma.
Bone marrow pattern
Focal pattern
Diffuse and variegated
patterns
mean ADC-values, *10¯³mm²/s
0.84±0,06
0.62±0,03
Conclusion
the meanings of ADC values of focal, both diffuse and variegated patterns of bone marrow have significant differences. The focal pattern of bone marrow has higher meanings of ADC, then diffuse and variegated. It can be explained more dense concentration of tumor cells in the limited focal area. Meanwhile, in a diffuse pattern, there is a larger area of infiltration, that's why the density and cellularity of tumor cells are less.
These differences in ADC-value could be an additional diagnostic tool for distinguishing patterns of...
Personal information and conflict of interest
N. Lutsik; Moscow/RU - nothing to disclose G. Yatsyk; Moscow/RU - nothing to disclose L. Mendeleeva; Moscow/RU - nothing to disclose M. Solovev; Moscow/RU - nothing to disclose V. Savchenko; Moscow/RU - nothing to disclose
References
1.Shortt CP, Gleeson TG, Breen KA, et al. Whole-Body MRI versus PET in assessment of multiple myeloma disease activity.AJR Am J Roentgenol 2009 Apr;192(4):980e6.
2.Kloth JK, Hillengass J, Listl K, et al. Appearance of monoclonal plasma cell disease in whole-body magnetic resonance imaging and correlation with parameters of disease activity.Int J Cancer 2014 Nov 15;135(10):2380e6.
3.A1 Baur, Stabler A, Bartl R, € et al. MRI gadolinium enhancement of bone marrow: age-related changes in normals and in diffuse neoplastic infiltration.Skeletal Radiol 1997 Jul;26(7):414e8.
4.Koutoulidis V, Fontara...