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Multiple myeloma (MM) is a blood cancer caused by the unlimited proliferation of intramedullary plasma cells. The presence of focal lesions (FLs) is presumed to be a more relevant factor for patient outcomes and risk distribution than diffuse bone marrow signal abnormalities. Signal changes in these FLs also have a good correlation with prognosis. As the cell density increased, a lower apparent diffusion coefficient (ADC) value was found with the diffusion-weighted imaging (DWI) sequence. Therefore, whole-body magnetic resonance imaging (MRI) with DWI sequences is sensitive to cell density and viability and may be vital for disease detection and therapy response assessments. However, the correlation between the DWI signal and the degree of bone destruction and the proportion of bone marrow plasma cells (BMPC) was still unclear in patients with MM. Water-fat separation MRI is used mainly for evaluating liver and bone marrow fat quantification, and fat quantification in other diseases. Meanwhile, it is also possible to assess the extent of bone marrow invasion in medullary lesions. This study aimed to investigate the correlation between ADC values from whole-body DWI and water/fat MRI signals from T1-weighted water-fat separation in evaluating bone marrow infiltration in patients with MM.

Evaluation of bone marrow infiltration in multiple myeloma using whole-body diffusion-weighted imaging and T1-weighted water- fat separation Dixon