Related Experiment Video
Updated: Apr 7, 2026
Author Spotlight: Integrating High-Resolution Intravital Imaging and MRI to Enhance Stereotactic Body Radiation Therapy Planning
Published on: April 12, 2024
Intravoxel Incoherent Motion Diffusion-weighted Imaging of Multiple Myeloma Lesions: Correlation with Whole-Body
Camille Bourillon1, Alain Rahmouni1, Chieh Lin1
1From the Department of Medical Imaging, AP-HP, Hôpitaux Universitaires Henri Mondor, 51 Avenue du Marechal de Lattre de Tassigny, 94010 Creteil Cedex, F-94010, France (C.B., A.R., P.B., P.Z., F.P., H.B., M.C., A.B., A.L.); Université Paris Descartes, Paris, France (C.B., C.A.C., A.L.); Faculty of Medicine, Université Paris Est Creteil, Creteil, France (A.R., M.C., C.H.); Department of Nuclear Medicine, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan (C.L.); Lymphomproliferative Unit, AP-HP, Hôpitaux Universitaires Henri Mondor, Creteil, France (K.B., C.H.); I2BM, CEA, Saclay, France (A.V.); Department of Radiology, AP-HP, Hôpital Européen Georges Pompidou, Paris, France (C.A.C.); and INSERM U 955, Equipe 18, Creteil, France (A.L.).
Purpose:
To correlate intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) parameters with the enhancement patterns of bone marrow and focal lesion obtained on whole-body (WB) dynamic contrast agent-enhanced (DCE) magnetic resonance (MR) images in patients with stage-III multiple myeloma (MM) before and after systemic therapy.
Materials And Methods:
Twenty-seven patients with MM were retrospectively included in this institutional review board-approved study. Requirement for written informed consent was waived. All patients underwent WB DCE MR imaging before treatment and 18 patients underwent repeat MR imaging 3 months after treatment. A transverse IVIM DWI sequence with 10 b values (0, 10, 20, 30, 50, 80, 100, 200, 400, and 800 sec/mm(2)) was acquired within bone marrow and focal lesions. The IVIM parameters (perfusion fraction [f], molecular diffusion coefficient [D], and perfusion-related D [D*]) and apparent diffusion coefficient (ADC) were extracted for both focal lesions and bone marrow and correlated with focal lesions and maximal bone marrow enhancement (BMEmax) (Spearman correlation coefficient) at baseline and at follow-up (Wilcoxon signed-rank test).
Results:
D and ADC values positively correlated with BMEmax (r = 0.7, P < .001; and r = 0.455, P = .0435, respectively). Patients with increased BMEmax showed significantly increased ADC and D within bone marrow versus patients who did not have increased BMEmax (ADC, 0.67 × 10(-3) mm(2)/sec vs 0.54 × 10(-3) mm(2)/sec, P = .03; D, 0.58 × 10(-3) mm(2)/sec vs 0.42 × 10(-3) mm(2)/sec, P < .001). Within focal lesions, f was the maximum in lesions that showed enhancement followed by washout. After treatment in good responders, the significant decrease in maximal enhancement value of focal lesions (baseline vs after treatment, 213.9% ± 78.7 [standard deviation] vs 131% ± 53.6, respectively; P < .001) was accompanied by a significant decrease in f (baseline vs after treatment, 11% ± 3.8 vs 5.8% ± 4.7, respectively; P < .001).
Conclusion:
Diffuse bone marrow involvement is associated with increased D. Hypervascular focal lesions with high maximal enhancement value of focal lesions also show high f value. Likewise, the decreased maximal enhancement value of focal lesions after treatment is accompanied by decreased f.
Insights
Intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) parameters correlate with bone marrow and lesion enhancement in multiple myeloma (MM). Increased diffusion (D) and ADC values in bone marrow, and perfusion fraction (f) in lesions, reflect disease activity and treatment response.
Area of Science:
- Radiology
- Oncology
- Medical Imaging
Background:
- Multiple myeloma (MM) is a hematologic malignancy affecting bone marrow.
- Whole-body (WB) dynamic contrast-enhanced (DCE) MRI provides insights into MM lesion vascularity.
- Intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) offers quantitative diffusion and perfusion information.
Purpose of the Study:
- To correlate IVIM-DWI parameters with enhancement patterns in bone marrow and focal lesions in MM patients.
- To assess these correlations before and after systemic therapy.
- To understand the relationship between imaging parameters and disease status.
Main Methods:
- Retrospective analysis of 27 MM patients undergoing WB DCE MRI and IVIM-DWI.
- IVIM parameters (f, D, D*) and ADC were extracted from bone marrow and focal lesions.
- Correlation analysis between IVIM-DWI parameters and maximal bone marrow enhancement (BMEmax) and lesion enhancement.
Main Results:
- D and ADC values positively correlated with BMEmax.
- Increased BMEmax was associated with significantly higher ADC and D in bone marrow.
- Within focal lesions, perfusion fraction (f) was highest in lesions with enhancement followed by washout.
- Treatment led to decreased lesion enhancement and a significant decrease in f in good responders.
Conclusions:
- Diffuse bone marrow involvement in MM is linked to increased diffusion (D).
- Hypervascular focal lesions with high enhancement exhibit a high perfusion fraction (f).
- Decreased lesion enhancement post-treatment correlates with a reduced perfusion fraction (f).
Related Concept Videos
01:24Magnetic Resonance Imaging
01:27Imaging Studies IV: Magnetic Resonance Imaging
01:30Radiological Investigation II: MRI and Ventilation Perfusion Scan
Magnetic Resonance Imaging (MRI) and Ventilation Perfusion Scans are two radiological investigations that offer detailed diagnostic images of the body, particularly lung structures.
MRI
MRI uses magnetic fields and radiofrequency signals to distinguish between normal and abnormal tissues. This technology provides a more detailed diagnostic image than CT scans, enabling it to characterize pulmonary nodules, stage bronchogenic carcinoma, and evaluate inflammatory activity in...
01:27Imaging Studies III: Computed Tomography
01:21Imaging Studies for Cardiovascular System IV: CMRI
01:25Imaging Studies II: Positron Emission Tomography and Scintigraphy
Fundamental Principles of PET