The diagnostic value of SE MRI and DWI of the spine in patients with monoclonal gammopathy of undetermined significance, smouldering myeloma and multiple myeloma

Objectives: To evaluate DWI of the bone marrow in the differentiation of monoclonal gammopathy of undetermined significance (MGUS), smouldering myeloma (SMM) and multiple myeloma (MM). Methods The retrospective study includes 64 patients with MGUS, 27 with SMM, 64 with new MM and 12 controls. Signal intensity (SI) of spinal SE-MRI and DWI (b0-1000) as well as apparent diffusion coefficients (ADC) were measured in the T10 and L3. Qualitative assessment of b-images was performed by one experienced radiologist. Results: ADC600 and ADC1000 are the best ADC values in differentiating patient groups (p50 % (p=0.001). Only SIT2 for L3 can differentiate MGUS from SMM (p=0.044) and PC%0-10 from PC%10-25 (p=0.033). Qualitative interpretation of b1000 images allows differentiating MM patients from those with MGUS or SMM (p