Mr imaging of multiple myeloma patients with bone-marrow transplants

Purpose: To evaluate the role of magnetic resonance (MR) imaging in the examination of multiple myeloma (MM) patients with bone-marrow transplants. Materials and Methods: A total of 40 MR examinations were made of 20 patients: 33 examinations of the spine and pelvis in 20/20 patients; and 7 examinations of the femora in 5/20 patients. The 40 examinations were evaluated and the results compared with those found at radiography. Altogether 13/20 pa- tients were re-examined: 10 after 1 year (one patient twice); and three after 2 years. Five sequences were tested, three of them first without and then with i.v. contrast enhancement. Results: In 24/33 exami nations, active MM lesions were shown by MR. In 16/33 examinations, MR showed greater spread and detectability than radiography. In the 5/20 femoral patients, three had a peripheral red bone-marrow extension in the femora. In the 13 re-examinations, the lesions had spread in four patients, were unchanged in seven, and had decreased in two. The lesions were easier to detect with the turbo inversion recovery (TIR) technique and with fat saturation than with the conventional spin-echo sequences. Contrast enhancement made the lesions more conspicuous in 8/17 examinations. Conclusions: MR has the potential to be a useful routine examination with T1-weighted and TIR sequences of selected areas, and without the use of contrast enhancement. However, further longitudinal studies are necessary in order to evaluate its possible predictive value.