Keywords:
Not applicable, Prospective, Lymphoma, Haematologic diseases, Imaging sequences, MR-Diffusion/Perfusion, MR, Oncology, Musculoskeletal bone, Haematologic, Oncologic Imaging, Performed at one institution
Authors:
N. Lutsik, G. Yatsyk, L. Mendeleeva, M. Solovev, V. Savchenko; Moscow/RU
DOI:
10.26044/ecr2020/C-03990
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 present a low signal on T1-weighted images with a high signal on STIR images, which are well-defined. The diffuse pattern is characterized by widespread diffuse replaced of normal bone marrow. A variegated pattern of bone marrow performs multiple tiny foci of infiltration among normal bone marrow [4]. The diffuse and focal pattern is a combination of two types of bone marrow infiltration patterns.
Diffusion-weighted imaging (DWI) is an additional diagnostic tool, which can provide information about bone marrow cellularity. This technique uses a stochastic Brownian motion of water molecules. Areas with higher cellularity demonstrate restriction of diffusion, which is hyperintense on DWI-images and hypointense on ADC-maps. DWI-MRI and ADC measurements can help to quantify disease burden [5-7]. ADC-values can vary in different bone marrow patterns [4]. Therefore, the purpose of our study was to evaluate the meanings of apparent diffusion coefficient for newly diagnosed plasma cell neoplasms depending on the pattern of bone marrow infiltration by using Whole Body MRI with DWIBS.