Whole-Body MRI with an Ultrahigh b-Value of 2000 s/mm2 Improves the Specificity of Diffusion-Weighted Imaging in Patients with Plasma Cell Dyscrasias

Anke Heidemeier, Annette Thurner, Corona Metz, Thomas Pabst, Heike Heidemeier, Leo Rasche, K Martin Kortüm, Hermann Einsele, Robert Grimm, Elisabeth Weiland, Thorsten Alexander Bley

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

3 Citations (Scopus)


RATIONALE AND OBJECTIVES: Our study compared sensitivity, specificity, and accuracy of whole-body diffusion-weighted imaging (WB-DWI) using a b-value of 2000 s/mm2 with that of the commonly used b-value of 800 s/mm2 for depiction of active tumor sites in patients with plasma cell diseases. We introduced an ultrahigh b-value to reduce interfering signals from benign and post-therapeutic inactive lesions by suppressing T2-shine-through effects.

MATERIALS AND METHODS: The prospective single-center study included patients when they went through a whole-body MRI (WB-MRI) staging or response evaluation procedure. The apparent diffusion coefficient (ADC) and morphologic appearance served as reference for classifying focal lesions on WB-DWI as vital or post-therapeutic. Additionally, we compared our classification with patients' serological markers of disease activity.

RESULTS: One hundred participants (65 ± 10 years, 58 men) underwent WB-DWI between June and October 2019. The detection rate of vital focal lesions was similar for both b-values with a sensitivity of 0.99 using b = 800 s/mm2 and 0.98 using b = 2000 s/mm2. By contrast, specificity and accuracy were 0.09 and 0.71 when using a b-value of 800 s/mm2, and 0.96 and 0.98 when using a b-value of 2000 s/mm2, respectively. The difference in specificity and accuracy was statistically significant (p < 0.001).

CONCLUSION: Using a b-value of 2000 s/mm2 significantly improved the specificity of lesion detection with WB-DWI as compared to the commonly used b-value of 800 s/mm2. The high b-value significantly reduced signal intensities of post-therapeutic or benign lesions and provided a significantly more accurate representation of active tumor load.

Original languageEnglish
Pages (from-to)e1-e8
JournalAcademic Radiology
Issue number1
Publication statusPublished - Jan 2022
Externally publishedYes


  • Diffusion Magnetic Resonance Imaging
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Paraproteinemias
  • Prospective Studies
  • Sensitivity and Specificity
  • Whole Body Imaging
  • Multiple myeloma
  • Plasma cell disease
  • b-Value
  • Diffusion-weighted MRI
  • b 2000 s/mm
  • Whole-body MRI

ASJC Scopus subject areas

  • Radiology, Nuclear Medicine and Imaging


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