Current concepts in tumor imaging with whole-body MRI with diffusion imaging (WB-MRI-DWI) in multiple myeloma and lymphoma

Whole-body MRI (WB-MRI) with diffusion-weighted imaging (DWI) can now be used to stage and restage multiple myeloma (MM) and lymphoma. Magnetic resonance imaging (MRI) is the standard tool to detect BM involvement (BMI). The 2016 diagnostic criteria of the International Myeloma Working Group identify WB-MRI and fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) as the most sensitive imaging techniques for detecting skeletal and extra-skeletal MM invasion, respectively. Preliminary findings have also shown that WB-MRI is better than CT and equal to PET/CT in staging aggressive lymphoma and Hodgkin lymphoma, whereas MRI is better for diagnosing BMI in patients with low-grade lymphoma. Signal intensity (SI) and the apparent diffusion coefficient (ADC) are useful metrics to quantify the chemotherapy response in WB-MRI.