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Dual-energy CT-based bone marrow imaging in multiple myeloma: Assessment of focal lesions in relation to disease status and MRI findings
Sebastian Werner1, Bernhard Krauss2, and Marius Horger1
1Radiology, University Hospital Tuebingen, Germany, Tuebingen, Germany, 2Siemens Healthineers, Forchheim, Germany
Virtual-non-calcium bone marrow imaging allows differentiation between active and inactive multiple myeloma. This is supported by a significant positive correlation between the attenuation and the ADC, as well as a corresponding inverse correlation to T1w signal intensity.

Figure 2

Example images of a 74 year old female patient with progressive multiple myeloma (first diagnosis 5 years and 3 months prior). The focal osteolytic lesion in the left dorsal iliac crest (arrow) is conspicuous in the CT as well as the VNCa image (mean VNCa attenuation 42.3 HU). In the T1w MRI image the lesion shows a homogeneous hypointense signal.

Figure 3

Example images of a 69 year old female patient with multiple myeloma in partial response (first diagnosis 3 years and 1 month prior). The focal osteolytic lesion in the right dorsal iliac crest is visible but not conspicuous in the CT image. The lesion is nicely depicted in the VNCa image (mean VNCa attenuation 7.6 HU). In the T1w MRI image the lesion shows moderate central hypointensity and a markedly hypointense rim which does not represent the typical appearance of an “active” lesion but is consistent with partial remission.