To illustrate the imaging findings in Patients with Multiple Myeloma (MM), studied by both Low-Dose CT (LD-CT) and Whole-Body MR (WB-MR).
To focus on advantages and disadvantages of these imaging techniques.
To illustrate the most common WB-MR pitfalls.
The high sensibility of WB-MR (including Diffusion Weighted Imaging) for bone marrow imaging and viability evaluation led this technique to an increasing role in the assessment of MM in each stage of disease.
WB-MR is now included into international standards for imaging patients with MM e.g.NICE guidelines (which suggests the use of WB-MR as first line imaging in Patients with a suspected diagnosis of MM) or British Society for Haematology (which recommends WB-MR for monitoring response of nonsecretory or oligosecretory myeloma).
WB-MR, however, is not...
Findings and procedure details
WB-MR acquisition protocol
WB-MR are performed on a 1,5T scanner. Patient is positioned supine headfirst, afterwards a 20-channel head-neck coil, two 18-channel body coils (covering the thoracic and abdominal-pelvic district and the femurs) are connected in combination with a 24-channel spine coil mounted directly on the bed scan.
Scan lasts approximately 45min.
No contrast agent is administered.
LD-CT acquisition protocol
LD-CT are performed on a 320-detector row scanner, scan extends from vertex to proximal tibia.
Scan time is approximately 45s;cumulative dose is about 4,5mSv.
WB-MR is the most appropriate imaging technique in MM management, given the recommendations of the new guidelines. This technique allows without Mean of Contrast and ionizing radiation an accurate diagnosis and therapeutic response assessment.
LD-CT is indicated if WB-MR is contraindicated and in centres where WB-MR is not available or Radiologist is not familiar enough with this technique.
Radiologist must know the imaging acquisition protocol, the most common WB-MR findings and pitfalls. However, familiarizing with DWI and different MM features requires a long learning curve....
Personal information and conflict of interest
G. Savietto; Pavia/IT - nothing to disclose M. V. V. Raciti; Pavia, IT/IT - nothing to disclose A. Maggi; Pavia/IT - nothing to disclose M. Zacchino; Pavia/IT - nothing to disclose E. M. Bassi; Pavia/IT - nothing to disclose F. Calliada; Pavia/IT - nothing to disclose L. Preda; Pavia/IT - nothing to disclose
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