TABLE 1

MRI Sequences to Include in WB PET/MRI Evaluation of Marrow Lesions

SequenceRecommended use
T1-weighted turbo spin echoEvaluation of cortex (normally dark) and marrow infiltration (marrow darker than normal)
Contrast-enhanced T2-weighted fat suppressionEvaluation for marrow edema and replacement; a T2-weighted fat-suppressed sequence (areas of edema and replacement are often brighter than background fat-containing marrow)
T2-weighted half-Fourier acquisition single-shot fast spin echoEvaluation of the full body and anatomic detail on organs and soft tissues; a fast-acquisition T2-weighted sequence
ADC DWI*Evaluation of lesion cellularity; a possible biomarker of treatment response
DCE MRI*Evaluation of limited regions such as in the case of a plasmacytoma; a surrogate for perfusion and permeability
Attenuation-corrected T1-weighted DixonCreation of a μ-map for attenuation correction of PET data; a dual-echo gradient recalled echo sequence that is acquired at in-phase and opposed-phase echo times with generation of fat-only and water-only images
  • * ADC DWI and DCE MRI sequences may be applied in a more focused way to characterize specific sites of disease and potentially add value in assessing tumor response. DCE is not a WB method.