Pictorial review of whole body MRI in myeloma: emphasis on diffusion-weighted imaging

Br J Radiol. 2020 Nov 1;93(1115):20200312. doi: 10.1259/bjr.20200312. Epub 2020 Aug 26.

Abstract

There have been major advances in myeloma imaging over the past few years with focal lesions on imaging now forming part of the disease defining criteria. Whole body diffusion-weighted MRI (WB-MRI) is considered the most sensitive technique for the detection of focal active lesions. This pictorial review will focus on imaging the spectrum of myelomatous disorders on WB-MRI including diffusion and Dixon sequences. The typical imaging patterns of disease are demonstrated including in the contexts of staging, presumed solitary plasmacytoma, smouldering myeloma and examples of paramedullary and extramedullary disease. The utility of diffusion-weighted imaging in response assessment is a major advantage and this will be exemplified here.

MeSH terms

  • Aged
  • Bone Marrow / diagnostic imaging
  • Bone Marrow Neoplasms / diagnostic imaging*
  • Bone Marrow Neoplasms / therapy
  • Diffusion Magnetic Resonance Imaging / methods*
  • Female
  • Humans
  • Incidental Findings
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Multiple Myeloma / diagnostic imaging*
  • Multiple Myeloma / therapy
  • Plasmacytoma / diagnostic imaging*
  • Whole Body Imaging / methods*