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Fig. 2 | Cancer Imaging

Fig. 2

From: Role of whole-body MRI for treatment response assessment in multiple myeloma: comparison between clinical response and imaging response

Fig. 2

A 70-year-old male with multiple myeloma demonstrating a discrepancy between imaging response and clinical response. MRI taken before chemotherapy (a) shows a nodular bone marrow lesion in the left ilium with T2 hyperintensity (upper right) and contrast enhancement (middle right). It shows diffusion restriction on ADC map (mean ADC value: 0.93 × 10− 3 mm2/s) (lower right). Follow-up MRI at 3 months (b) and 8 months (c) show gradual increase in the size of the bone marrow lesion with extraosseous soft tissue extension involving the left iliacus and gluteus medius. Aggravation of diffusion restriction was noted on follow-up ADC maps (mean ADC value: 0.70 ~ 0.78 × 10− 3 mm2/s). Clinical markers improved over the same period (serum M-protein: 2.1 ➔ 0 g/dl); however, despite the improvement in the laboratory markers, the treatment regimen was changed according to the disease progression on the imaging response

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