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Intravoxel incoherent motion diffusion-weighted magnetic resonance imaging of focal vertebral bone marrow lesions: initial experience of the differentiation of nodular hyperplastic hematopoietic bone marrow from malignant lesions

Authors
 Sunghoon Park  ;  Kyu-Sung Kwack  ;  Nam-Su Chung  ;  Jinwoo Hwang  ;  Hyun Young Lee  ;  Jae Ho Kim 
Citation
 SKELETAL RADIOLOGY, Vol.46(5) : 675-683, 2017-03 
Journal Title
SKELETAL RADIOLOGY
ISSN
 0364-2348 
Issue Date
2017-03
MeSH
Adult ; Aged ; Aged, 80 and over ; Bone Marrow / diagnostic imaging ; Bone Marrow Diseases / diagnostic imaging ; Bone Marrow Neoplasms / diagnostic imaging* ; Diagnosis, Differential ; Diffusion Magnetic Resonance Imaging / methods* ; Female ; Humans ; Male ; Middle Aged ; Reproducibility of Results ; Retrospective Studies ; Sensitivity and Specificity ; Spinal Neoplasms / diagnostic imaging* ; Spine / diagnostic imaging
Keywords
Bone marrow ; Diffusion ; Hyperplastic hematopoietic bone marrow ; Intravoxel incoherent motion ; Magnetic resonance imaging ; Metastasis ; Spine
Abstract
Objective: To evaluate the ability of intravoxel incoherent motion (IVIM) diffusion-weighted magnetic resonance imaging (MRI) parameters to differentiate nodular hyperplastic hematopoietic bone marrow (HHBM) from malignant vertebral bone marrow lesions (VBMLs).

Materials and methods: A total of 33 patients with 58 VBMLs, including 9 nodular HHBM lesions, 39 bone metastases, and 10 myelomas, were retrospectively assessed. All diagnoses were confirmed either pathologically or via image assessment. IVIM diffusion-weighted MRI with 11 b values (from 0 to 800 s/mm2) were obtained using a 3.0-T MR imager. The apparent diffusion coefficient (ADC), pure diffusion coefficient (D), perfusion fraction (f), and pseudodiffusion coefficient (D*) were calculated. ADC and IVIM parameters were compared using the Mann-Whitney U test. Receiver operating characteristic (ROC) curve analysis was performed to assess the diagnostic performances of ADC, D, f, and D* in terms of VBML characterization. The diagnostic performance of morphological MR sequences was also assessed for comparison.

Results: The ADC and D values of nodular HHBM were significantly lower than those of malignant VBML (both p values < 0.001), whereas the f value was significantly higher (p < 0.001). However, there were no significant differences in D* between the two groups (p = 0.688). On ROC analysis, the area under the curve (AUC) for D was 1.000, which was significantly larger than that for ADC (AUC = 0.902).

Conclusion: Intravoxel incoherent motion diffusion-weighted MRI can be used to differentiate between nodular HHBM and malignant VBML. The D value was significantly lower for nodular HHBM, and afforded a better diagnostic performance than the ADC, f, and D* values in terms of such differentiation.
Full Text
https://link.springer.com/article/10.1007/s00256-017-2603-z
DOI
10.1007/s00256-017-2603-z
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Biomedical Systems Informatics (의생명시스템정보학교실) > 1. Journal Papers
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/195895
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