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Imaging Features of Multiple Myeloma Extramedullary Lesions in the Liver with 18F-FDG PET/CT, Contrast-Enhanced CT and MRI

1
Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
2
Internal Medicine V and National Center for Tumor Diseases (NCT), University Clinic Heidelberg, 69120 Heidelberg, Germany
*
Author to whom correspondence should be addressed.
Diagnostics 2019, 9(4), 179; https://doi.org/10.3390/diagnostics9040179
Received: 17 October 2019 / Revised: 2 November 2019 / Accepted: 4 November 2019 / Published: 7 November 2019
(This article belongs to the Section Medical Imaging)
Ηepatic involvement in multiple myeloma is not common; nevertheless, it is associated with poorer outcome. Heterogeneous features have been described in few published reports so far. We present the imaging findings of PET/CT in comparison to those of MRI for two multiple myeloma (MM) patients, one with a liver lesion suspicious for myeloma metastasis on PET and one with multiple liver lesions suspicious for myeloma metastases on MRΙ. The subsequent ultrasound-guided needle biopsies confirmed the extramedullary spread of the disease in both patients. The first case exhibited a match in both functional imaging modalities (PET and MRI) but a mismatch of intense metabolic activity on 18F-fluorodeoxyglucose (18F-FDG) PET/CT and iso-attenuating liver parenchyma on contrast-enhanced CT. The second case showed a mismatch of signal elevation persistence on diffusion-weighted imaging (DWI) and physiologic 18F-FDG distribution in the liver parenchyma. These cases present different imaging features in MM lesions of the liver using PET/CT and MRI, reflecting the high disease heterogeneity in patients with MM and demonstrating that the use of both PET/CT and MRI may offer complementary information. View Full-Text
Keywords: multiple myeloma; extramedullary; 18F-FDG PET/CT; MRI; contrast-enhanced CT multiple myeloma; extramedullary; 18F-FDG PET/CT; MRI; contrast-enhanced CT
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Papamichail, D.; Hog, R.; Goldschmidt, H.; Dimitrakopoulou-Strauss, A. Imaging Features of Multiple Myeloma Extramedullary Lesions in the Liver with 18F-FDG PET/CT, Contrast-Enhanced CT and MRI. Diagnostics 2019, 9, 179.

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