Multi-parametric whole-body MRI evaluation discerns vital from non-vital multiple myeloma lesions as validated by 18F-FDG and 11C-methionine PET/CT

Anke Heidemeier, Wiebke Schloetelburg, Annette Thurner, Corona Metz, Heike Heidemeier, Leo Rasche, K Martin Kortuem, David Boeckle, Elisabeth Weiland, Thomas Benkert, Dominik Nickel, Rudolf Werner, Andreas Konrad Buck, Thorsten Alexander Bley

Research output: Journal article (peer-reviewed)Journal article

4 Citations (Scopus)


PURPOSE: We tested a novel multi-parametric (mp) whole body (WB)-MRI evaluation algorithm for medullary lesions in comparison to positron emission tomography (PET) radiotracers 18F-fluorodeoxyglucose (18F-FDG) and 11C-methionine (11C-MET).

METHODS AND MATERIALS: This retrospective single-center study included 44 MM patients, who received both 18F-FDG-PET and WB-MRI within ten days. MRI classified focal lesions as vital when showing 1) significant diffusion-restriction, 2) a fat fraction (FF) less than 20 % and 3) homogenous hypointensity on T2-weighted images. On a lesion-by-lesion level the findings were compared to 18F-FDG PET by using a 5-point scoring system (analogous to the Deauville score [DS]). In 24/44 (55 %) patients additional comparison to 11C-MET PET was available.

RESULTS: Among two radiologists, an excellent inter-observer reliability for mpWB-MRI in a total of 84 medullary lesions was observed (ICC = 1, k = 1, p <.01). 16/17 (94.1 %) MRI-classified vital lesions had a DS of 4 or 5 on either 18F-FDG-PET or 11C-MET-PET. MRI-rated non-vital lesions correlated with PET-based DS ≤ 3. When results of mpWB-MRI were compared to 18F-FDG, a fair inter-observer agreement was recorded (ICC = 0.52, k = 0.53, p <.01), while for 11C-MET, an excellent concordance rate was achieved (ICC = 0.81, k = 0.79, p <.01).

CONCLUSION: The proposed mpWB-MRI interpretation algorithm allowed to assess tumor activity of myeloma lesions with high inter-observer reproducibility. We observed a substantial concordance between the mpWB-MRI classification of lesions and PET assessment based on a semi-automatically calculated 5-point scoring system analogous to the Deauville scores.

Original languageEnglish
Article number110493
Pages (from-to)110493
JournalEuropean Journal of Radiology
Publication statusPublished - Oct 2022
Externally publishedYes


  • Fluorodeoxyglucose F18
  • Humans
  • Magnetic Resonance Imaging/methods
  • Methionine
  • Multiple Myeloma/diagnostic imaging
  • Positron Emission Tomography Computed Tomography/methods
  • Positron-Emission Tomography/methods
  • Racemethionine
  • Radiopharmaceuticals
  • Reproducibility of Results
  • Retrospective Studies
  • Tomography, X-Ray Computed/methods
  • Multi-parametric MRI
  • Multiple myeloma
  • C-methionine
  • F-FDG
  • Fat fraction
  • Diffusion-weighted MRI
  • Positron emission tomography
  • Whole-body MRI
  • PET
  • Chemical shift imaging

ASJC Scopus subject areas

  • Radiology, Nuclear Medicine and Imaging


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