Contrast Ratio of Myeloma Focal Lesions Relative to Surrounding Bone Marrow Is Higher on T2-weighted Dixon Images Than on T1-weighted Images

Purpose: We compared the contrast ratio of spinal multiple myeloma focal lesions to surrounding bone marrow on T2-weighted Dixon (T2wD) images versus T1-weighted (T1w) spin-echo images, and we searched for a correlation between fat fraction of bone marrow assessed by T2wD sequence and extended calcemia renal anemia bone (CRAB) data.

Methods and Materials: A total of 112 focal lesions from 39 retrospectively included patients were analyzed on sagittal T1w sequences and sagittal T2sD sequences with water-only, fat-only, in-phase, and out-of-phase images of the whole spine. Contrast between focal lesions and bone marrow was calculated and compared by analysis of variance and post hoc Tukey tests. The correlation between fat fraction and extended CRAB data was assessed using Spearman’s correlation coefficient.

Results: Contrast of lesions on T2wD images was significantly higher than that on T1w images (p < 0.0001). Contrast was highest on T2wD fat-only (0.63 ± 0.21), intermediate on T2wD water-only (0.45 ± 0.20), and lowest on T1w images (0.23 ± 0.19). There was no significant correlation between extended CRAB data and fat fraction.

Conclusion: To analyze myeloma focal lesions, a T2wD sequence may be used singly instead of the classical association of T1w plus another fat-suppressed fluid-sensitive sequence.