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Congress: ECR25
Poster Number: C-11371
Type: Poster: EPOS Radiologist (educational)
Authorblock: P. Del Nido Recio, A. Paternain Nuin, M. R. López De La Torre Carretero, M. B. Barrio Piqueras, M. Jiménez Vázquez, C. Mbongo, C. Urtasun Iriarte, D. A. Zambrano, J. D. Aquerreta; Pamplona/ES
Disclosures:
Pablo Del Nido Recio: Nothing to disclose
Alberto Paternain Nuin: Nothing to disclose
Manuel Rafael López De La Torre Carretero: Nothing to disclose
Miguel Barrio Barrio Piqueras: Nothing to disclose
Marcos Jiménez Vázquez: Nothing to disclose
Carmen Mbongo: Nothing to disclose
Cesar Urtasun Iriarte: Nothing to disclose
Daniel Alfonso Zambrano: Nothing to disclose
Jesús Dámaso Aquerreta: Nothing to disclose
Keywords: Haematologic, Musculoskeletal bone, Musculoskeletal soft tissue, MR-Diffusion/Perfusion, PET-CT, Diagnostic procedure, Haematologic diseases
Learning objectives To study the role of imaging techniques in the follow-up of multiple myeloma (MM). To evaluate disease response and progression criteria using whole-body diffusion-weighted magnetic resonance imaging (WB DW-MRI) and 18F-Fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT).   
Read more Background WB DW-MRI and 18 F-FDG PET/TC are valuable tools for the diagnosis and follow-up of MM. 18 F-FDG PET/CT is considered the gold standard for assessing extramedullary disease, while WB-DWI offers greater sensitivity in detecting diffuse disease, especially in cases of non-nonsecretory myeloma (figure 1). [fig 1] A standardized protocol has been proposed for WB DW-MRI (figure 2). [fig 2] On MRI, signs of the disease include (figures 3 y 4 ):  Focal or diffuse signal intensity (SI) abnormalities with a diameter > 5 mm. Paramedullary...
Read more Findings and procedure details  WB DW-MRI and MY-RADS:Diffusion-weighted imaging (DWI) has added advantages in the MR imaging of MM (figure 10): Direct evaluation of bone marrow. High Sensitivity (Gold Standard for diffuse disease). Prognostic Value → The number and size of focal lesions correlate with global survival (Hillengass et al. 2010). Analysis of cellularity and viability → crucial in evaluating early response to treatment before changes in lesions’ size are depicted. The Myeloma Response Assessment and Diagnosis System (MY-RADS) characterizes the myeloma state, both at diagnosis and during therapy...
Read more Conclusion Both Whole-body diffusion-weighted MR imaging (WB-DWI) and FDG-PET/CT are useful in the follow-up of bone marrow infiltrative lesions. It is crucial to correlate the morphology of the lesions with diffusion-weighted values (MRI) and with up-take values (FDG-PET/TC). FDG-PET/TC is the gold standard for studying extramedullary disease, whereas WB-DWI has more sensitivity in depicting diffuse disease and non-secretor myeloma.
Read more References [1] Filho AGO, Carneiro BC, Pastore D, Silva IP, Yamashita SR, Consolo FD, et al. Whole-body imaging of multiple myeloma: Diagnostic criteria. Radiographics 2019;39:1077–97. https://doi.org/10.1148/rg.2019180096 [2] Hillengass J, Fechtner K, Weber MA, Bäuerle T, Ayyaz S, Heiss C, et al. Prognostic significance of focal lesions in whole-body magnetic resonance imaging in patients with asymptomatic multiple myeloma. J Clin Oncol 2010;28:1606–10. https://doi.org/10.1200/JCO.2009.25.5356. [3] Messiou C, Hillengass J, Delorme S, Lecouvet FE, Moulopoulos LA, Collins DJ, et al. Guidelines for acquisition, interpretation, and reporting...
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