MULTIPLE-MYELOMA - MR PATTERNS OF RESPONSE TO TREATMENT

PURPOSE: To assess changes in the magnetic resonance (MR) appearance o f the spine in patients with multiple myeloma who responded to chemoth erapy. MATERIALS AND METHODS: Twenty patients with multiple myeloma un derwent MR imaging of the spine before and after chemotherapy. Sagitta l T1-weighted images were obtained before and after administration of contrast material. MR patterns of marrow involvement before treatment were classified as focal, diffuse, or variegated. The changes seen on MR images after treatment were analyzed and correlated with the clinic al response as defined with standard criteria. RESULTS: Patterns of co mplete response included resolution of marrow abnormality or persisten t abnormality without enhancement or with peripheral rim enhancement. Conversion of a diffuse to a variegated or focal pattern and a decreas e in the amount df marrow abnormality with persistent enhancement were observed in patients who showed a partial response. Ten patients sust ained new ok progressive compression fractures after successful therap y. CONCLUSION: Recognition of spinal MR patterns of response to treatm ent supported the occurrence of remission in patients with multiple my eloma. MR findings may help clarify response to therapy in patients wi th equivocal clinical changes or nonsecretory myeloma.