Quantitative bone marrow magnetic resonance imaging through apparent diffusion coefficient and fat fraction in multiple
- PDF / 1,002,085 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 34 Downloads / 214 Views
MUSCULOSKELETAL RADIOLOGY
Quantitative bone marrow magnetic resonance imaging through apparent diffusion coefficient and fat fraction in multiple myeloma patients Sara Berardo1 · Lidiia Sukhovei1 · Silvano Andorno2 · Alessandro Carriero1 · Alessandro Stecco1 Received: 13 November 2019 / Accepted: 10 August 2020 © Italian Society of Medical Radiology 2020
Abstract Objective Quantitative bone marrow (BM) MR sequences, as DWI and CSI, were used to evaluate BM water–fat composition. The aim of the study was to assess the potential usefulness of fat fraction (FF) and ADC, calculated by CSI or DWI, in diagnosing and classifying myeloma (MM) patients according to their different BM infiltration patterns. Methods The study group included 43 MM patients (19F; 24M; mean age 64 years), 15 asymptomatic, 15 symptomatic with diffuse BM infiltration and 13 symptomatic with focal lesions (FLs). The control group was made up of 15 healthy subjects (7F; 8M; mean age 64 years). MRI examinations consisted of sagittal T1w TSE on the spinal column, axial DWI (b 50–400–800 mm2/s) and coronal T2 Dixon, on the whole body. Mean ADC and FF were calculated placing 1 ROI on 6 vertebras and 2 ROIs on either the pelvis or FL. Results ANOVA with Bonferroni’s correction showed a significant difference in ADC values among the different groups of MM patients (P 5 mm is considered the main criterion for MM diagnosis, the following five additional MRI patterns of BM involvement have been reported: (1) normal appearance of BM, observed in 30% of patient; (2) focal involvement (in 30% of patient); (3) homogeneous diffuse infiltration; (4) diffuse infiltration plus focal lesions (in 10% of patient); and (5) salt-and-pepper pattern (in 3–5% of patient) [5]. Diffuse BM infiltration is defined by means of T1-weighted sequences, which can reconstruct it as diffuse low signal intensity due to the presence of interstitial plasma cell infiltration resembling BM hyperplasia [6]. Because the diffuse BM infiltration pattern is associated with an higher risk of disease progression and worse prognosis [7–9], recent studies have underscored the importance of using DWI and apparent diffusion coefficient (ADC) to increase the diagnostic confidence when analyzing different MRI patterns with quantitative methods. Particularly, ADC mean values for normal BM, obtained by DWI sequences, are generally very low (i.e., 0.2–0.5 × 10–3 mm2/s) due to the abundance of marrow fat, whereas the neoplastic growth appears as an area of increased diffusivity [3]. Another important approach for quantitative evaluation of BM involvement is represented by MRI fat fraction (FF) quantification by chemical shift imaging (CSI), which calculates the signal arising from fat protons divided by the sum
of the signals from fat and water protons [10–12]. There are scarce reports investigating the use of FF to evaluate bone composition in MM patients, and there are no reference values in clinical practice. Thus, the aim of our study was to evaluate the usefulness of ADC and FF measurements f
Data Loading...
