Role of MRI for the diagnosis and prognosis of multiple myeloma

The Evolution of Prognostic Factors in Multiple Myeloma

“…However, even in stage I disease (Durie and Salmon) and negative X-ray films bone marrow infiltration in MRI may be detected in 29–50% of patients. Those patients typically show an earlier disease progression [84]. IMWG consensus considered MRI to be the gold-standard imaging technique for detection of bone morrow involvement [85].…”

Multiple Myeloma: A Review of Imaging Features and Radiological Techniques

“…Whole-body MR (WBMR) has emerged as the most sensitive imaging modality to date at detecting diffuse and focal multiple myeloma in the spine, as well as the extra-axial skeleton [19–21]. Due to its ability to visualise large volumes of bone marrow without inducing radiation exposure and in an acceptable amount of time, MR imaging has become a favoured imaging method for evaluating disease within the bone marrow (Figure 6).…”

“…A complete response to treatment may be evidenced by complete resolution of the preceding marrow abnormality, and a partial response demonstrated by conversion of a diffuse to a variegated or focal pattern [22]. A good response to treatment may also be evidenced by a reduction in signal intensity on T2-weighted spin echo images and the absence of contrast-induced rim enhancement that was previously present [19]. …”

MRI for Response Assessment In Oncologic Bone Marrow Lesions

“…The morphologic changes indicative of response include reduction in focal lesion size, return from a focal or diffuse pattern of neoplastic marrow involvement to a normal bone marrow appearance, decrease in diffuse marrow enhancement, and in focal lesion enhancement after contrast injection, with sometimes a residual peripheral enhancement halo (Moulopoulos et al 1994). The lack of enhancement within a treated lesion should be considered carefully, as residual viable myeloma cells may be observed in this setting (Baur-Melnyk et al 2005;Lecouvet et al 1998a;Lecouvet et al 2001). The complete disappearance of focal lesions with return to a completely normal marrow signal may be a very slow process (Hanrahan et al 2010).…”

“…This radiographic survey has a limited value for disease follow-up, as the comparison with MRI clearly demonstrates the frequent persisting visibility of lytic areas on radiographs despite evident signs of response based on the bone marrow signal changes at MRI (Baur-Melnyk et al 2005;Moulopoulos et al 1994).…”