Skip to main content
SpringerLink
Log in

Signal characteristics of focal bone marrow lesions in patients with multiple myeloma using whole body T1w-TSE, T2w-STIR and diffusion-weighted imaging with background suppression

  • Musculoskeletal
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objective

This study analyses the diagnostic potential of Diffusion-Weighted Imaging with Background Suppression (DWIBS) in the detection of focal bone marrow lesions from multiple myeloma. The signal and contrast properties of DWIBS are evaluated in correlation with the serum concentration of M-component (MC) and compared with established T1- and T2-weighted sequences.

Methods

Data from 103 consecutive studies in 81 patients are analysed retrospectively. Signal intensities and apparent Diffusion Coefficients (ADC) of 79 focal lesions in the lumbar spine or pelvis of 38 patients are determined and contrast-to-noise-ratio (CNR) is calculated. Data from patients with low (<20 g/L) and high (>20 g/dL) MC are evaluated separately.

Results

Signal intensities of focal myeloma lesions on T2w-STIR vary significantly depending on the MC, which leads to a loss in CNR in patients with high MC. No signal variation is observed for T1w-TSE and DWIBS. The CNR values provided by DWIBS in patients with high MC are slightly higher than those of T2w-STIR. ADC values in patients with low MC are significantly higher than in patients with high MC.

Conclusion

Whole-body DWIBS has the potential to improve the conspicuity of focal myeloma lesions and provides additional biological information by ADC quantification.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Ghanem N, Lohrmann C, Engelhardt M, Pache G, Uhl M, Saueressig U et al (2009) Whole-body MRI in the detection of bone marrow infiltration in patients with plasma cell neoplasms in comparison to the radiological skeletal survey. Eur Radiol 16:1005–1014

    Article  Google Scholar 

  2. Dinter DJ, Neff WK, Klaus J, Bohm C, Hastka J, Weiss C et al (2009) Comparison of whole-body MR imaging and conventional X-ray examination in patients with multiple myeloma and implications for therapy. Ann Hematol 88:457–464

    Article  PubMed  Google Scholar 

  3. Dimopoulos M, Terpos E, Comenzo RL, Tosi P, Beksac M, Sezer O et al (2009) International myeloma working group consensus statement and guidelines regarding the current role of imaging techniques in the diagnosis and monitoring of multiple Myeloma. Leukemia 23:1545–1556

    Article  PubMed  CAS  Google Scholar 

  4. Lecouvet FE, Malghem J, Michaux L, Maldague B, Ferrant A, Michaux JL et al (1999) Skeletal survey in advanced multiple myeloma: radiographic versus MR imaging survey. Br J Haematol 106:35–39

    Article  PubMed  CAS  Google Scholar 

  5. Baur-Melnyk A, Buhmann S, Becker C, Schoenberg SO, Lang N, Bartl R et al (2008) Whole-body MRI versus whole-body MDCT for staging of multiple myeloma. AJR Am J Roentgenol 190:1097–1104

    Article  PubMed  Google Scholar 

  6. Ailawadhi S, Abdelhalim AN, Derby L, Mashtare TL, Miller KC, Wilding GE et al (2010) Multiple myeloma treatment response assessment with whole-body dynamic contrast-enhanced MR imaging. Cancer 254:521–531

    Google Scholar 

  7. Durie BGM (2006) The role of anatomic and functional staging in myeloma: description of Durie/Salmon plus staging system. Eur J Cancer 42:1539–1543

    Article  PubMed  Google Scholar 

  8. Baur A, Stabler A, Steinborn M, Schnarkowski P, Pistitsch C, Lamerz R et al (1998) Magnetresonanztomographie beim Plasmozytom: Wertigkeit verschiedener Sequenzen bei diffuser und fokaler Infiltrationsform. Rofo 168:323–329

    PubMed  CAS  Google Scholar 

  9. Takahara T, Imai Y, Yamashita T, Yasuda S, Nasu S, Van Cauteren M (2004) Diffusion weighted whole body imaging with background body signal suppression (DWIBS): technical improvement using free breathing, STIR and high resolution 3D display. Radiat Med 22:275–282

    PubMed  Google Scholar 

  10. Sakurada A, Takahara T, Kwee TC, Yamashita T, Nasu S, Horie T et al (2009) Diagnostic performance of diffusion-weighted magnetic resonance imaging in esophageal cancer. Eur Radiol 19:1461–1469

    Article  PubMed  Google Scholar 

  11. Kwee TC, Takahara T, Ochiai R, Katahira K, Van Cauteren M, Imai Y et al (2009) Whole-body diffusion-weighted magnetic resonance imaging. Eur J Radiol 70:409–417

    Article  PubMed  Google Scholar 

  12. Kwee TC, Takahara T, Ochiai R, Nievelstein RAJ, Luijten PR (2008) Diffusion-weighted whole-body imaging with background body signal suppression (DWIBS): features and potential applications in oncology. Eur Radiol 18:1937–1952

    Article  PubMed  Google Scholar 

  13. Matsumoto Y, Kuroda M, Matsuya R, Kato H, Shibuya K, Oita M et al (2009) In vitro experimental study of the relationship between the apparent diffusion coefficient and changes in cellularity and cell morphology. Oncol Rep 22:641–648

    PubMed  Google Scholar 

  14. Takenaka D, Ohno Y, Matsumoto K, Aoyama N, Onishi Y, Koyama H et al (2009) Detection of bone metastases in non-small cell lung cancer patients: comparison of whole-body diffusion-weighted imaging (DWI), whole-body MR imaging without and with DWI, whole-body FDG-PET/CT, and bone scintigraphy. J Magn Reson Imaging 30:298–308

    Article  PubMed  Google Scholar 

  15. Bohlscheid A, Nuss D, Lieser S, Busch H (2008) Tumorsuche mittels kernspintomografischer Diffusionsbildgebung–Erste Erfahrungen. Rofo 180:302–309

    PubMed  CAS  Google Scholar 

  16. Balliu E, Vilanova JC, Pelaez I, Puig J, Remollo S, Barcelo C et al (2009) Diagnostic value of apparent diffusion coefficients to differentiate benign from malignant vertebral bone marrow lesions. Eur J Radiol 69:560–566

    Article  PubMed  CAS  Google Scholar 

  17. Pui MH, Mitha A, Rae WID, Corr P (2005) Diffusion-weighted magnetic resonance imaging of spinal infection and malignancy. J Neuroimaging 15:164–170

    PubMed  Google Scholar 

  18. Raya JG, Dietrich O, Reiser MF, Baur-Melnyk A (2005) Techniques for diffusion-weighted imaging of bone marrow. Eur J Radiol 55:64–73

    Article  PubMed  CAS  Google Scholar 

  19. Durie BG (1986) Staging and kinetics of multiple myeloma. Semin Oncol 13:300–309

    PubMed  CAS  Google Scholar 

  20. Schmidt GP, Baur A, Stabler A, Schoenberg SO, Steinborn M, Baltin V et al (2005) Beurteilbarkeit diffuser Knochenmarksinfiltrationen der Wirbelsaule bei multiplem Myelom: Korrelation von MRT-Befunden mit der Histologie. Rofo 177:745–750

    PubMed  CAS  Google Scholar 

  21. Wasser K, Moehler T, Nosas-Garcia S, Rehm C, Bartl R, Goldschmidt H et al (2005) Korrelation zwischen MRT und Histopathologie des Knochenmarks bei Patienten mit Multiplem Myelom. Rofo 177:1116–1122

    PubMed  CAS  Google Scholar 

Download references

Acknowledgements

The authors acknowledge Thomas Egelhof MD, Department of Radiology, Merian Iselin Hospital Basel for his fruitful contribution to the conception and initiation of this work.

We also thank Siemens Healthcare for providing customized DWI sequences.

This work was supported by Bayer Schering Pharma, Switzerland. The study sponsor played no role in matters of design, collection, analysis, interpretation of data, and writing the report.

Author information

Authors and Affiliations

  1. Department of Radiology, University of Basel Hospital, Petersgraben 4, CH-4031, Basel, Switzerland

    Gregor Sommer, Georg Bongartz & Leopold Winter

  2. Department of Radiology, Division of Radiological Physics, University of Basel Hospital, Petersgraben 4, CH-4031, Basel, Switzerland

    Markus Klarhöfer, Claudia Lenz & Klaus Scheffler

Authors
  1. Gregor Sommer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Markus Klarhöfer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Claudia Lenz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Klaus Scheffler
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Georg Bongartz
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Leopold Winter
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gregor Sommer.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sommer, G., Klarhöfer, M., Lenz, C. et al. Signal characteristics of focal bone marrow lesions in patients with multiple myeloma using whole body T1w-TSE, T2w-STIR and diffusion-weighted imaging with background suppression. Eur Radiol 21, 857–862 (2011). https://doi.org/10.1007/s00330-010-1950-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-010-1950-0

Keywords

Search

Navigation