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Objective: To evaluate the role of diffusion-weighted imaging (DWI) in the initial diagnosis, staging, and assessment of treatment response in patients with multiple myeloma (MM). Materials and methods: A systematic literature review was conducted in PubMed, the Cochrane Library, EMBASE, Scopus, and Web of Science databases. The primary endpoints were defined as the diagnostic performance of DWI for disease detection, staging of MM, and assessing response to treatment in these patients. Results: Of 5881 initially reviewed publications, 33 were included in the final qualitative and quantitative meta-analysis. The diagnostic performance of DWI in the detection of patients with MM revealed pooled sensitivity and specificity of 86% (95% CI: 84–89) and 63% (95% CI: 56–70), respectively, with a diagnostic odds ratio (OR) of 14.98 (95% CI: 4.24–52.91). The pooled risk difference of 0.19 (95% CI: − 0.04–0.42) was reported in favor of upstaging with DWI compared to conventional MRI (P value = 0.1). Treatment response evaluation and ADCmean value changes across different studies showed sensitivity and specificity of approximately 78% (95% CI: 72–83) and 73% (95% CI: 61–83), respectively, with a diagnostic OR of 7.21 in distinguishing responders from non-responders. Conclusions: DWI is not only a promising tool for the diagnosis of MM, but it is also useful in the initial staging and re-staging of the disease and treatment response assessment. This can aid clinicians with earlier initiation or change in treatment strategy, which could have prognostic significance for patients. [ABSTRACT FROM AUTHOR]

Magnetic resonance imaging (MRI) demonstrated that the lesion was predominantly hyperintense on T1-weighted imaging with fat saturation, associated with peripheral gadolinium-enhancement and restricted diffusion. The case presentation can be found at doi: 10.1007/s00256-021-03838-0 Question: A 43-year-old prison guard man with right knee pain for 3 months following prolonged standing at work Answer: A 43-year-old prison guard man with right knee pain for 3 months following prolonged standing at work Diagnosis: Melanoma metastasis Discussion A radiograph of the right knee showed a lucent oval lesion in the right distal femoral epiphysis (Fig. The femur and tibia are affected in only 7% of patients with bone metastasis from malignant melanoma, and the lesion usually arises eccentrically in the distal femoral epiphysis [[3], [5]]. [Extracted from the article]

Abstract  We report the development of isolated lower extremity metastases, in a child, 9 years after her initial diagnosis and treatment of bilateral infantile retinoblastomas. The radiographic, scintigraphic, computed tomographic, and magnetic resonance imaging findings are discussed. The dominant metastatic focus was blastic, involving the medial cuneiform. Additional occult lesions were found in the base of the second metatarsal, middle cuneiform, navicular and tibial diaphysis. An open biopsy confirmed the diagnosis. The occurrence of late distant metastases is rare in the USA. [ABSTRACT FROM AUTHOR]

Two cases of osteogenic sarcoma with skeletal muscle metastases are described. A 40-year-old woman presented with progressive swelling of both calves and a soft tissue back lump. She had been diagnosed with mandibular chondroblastic osteogenic sarcoma 6 years earlier. Radiographs showed calcified masses. MRI scans and bone scintigraphy revealed multiple soft tissue masses in both calves. Bone scintigraphy also showed uptake in the back lump, right thigh and left lung base. Biopsy confirmed metastatic chondroblastic osteogenic sarcoma, which initially responded well to chemotherapy. However, the metastatic disease subsequently progressed rapidly and she died 21 months after presentation. The second case concerns a 20-year-old man who presented with a pathologic fracture of the humerus, which was found to be due to osteoblastic osteogenic sarcoma. He developed cerebral metastases 17 months later, followed by metastases at other sites. Calcified masses were subsequently seen on radiographs of the abdomen and chest. CT scans confirmed the presence of densely calcified muscle metastases in the abdominal wall, erector spinae and gluteal muscles. The patient’s disease progressed rapidly and he died 30 months after presentation. [ABSTRACT FROM AUTHOR]