Advanced MR imaging of bone marrow: quantification of signal alterations on T1-weighted Dixon and T2-weighted Dixon sequences in red marrow, yellow marrow, and pathologic marrow lesions

Sasiponganan, Chayanit; Yan, Kevin; Pezeshk, Parham; Xi, Yin; Chhabra, Avneesh

doi:10.1007/s00256-019-03303-z

Cited by 18 publications

(6 citation statements)

References 15 publications

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“…Currently, there are no research reports on using dual-energy CT VNCa bone marrow imaging technology to differentiate MM with diffuse bone marrow infiltration from RBM, whereas MRI is the most commonly used modality for obtaining Signal Intensity Ratios or Fat Fraction through water and lipid imaging to measure changes in bone marrow signal quantitatively. [26][27][28] Akman B used these techniques to differentiate the reverse conversion of RBM from bone marrow malignant lesions and reported an AUC of 0.825 when using a signal intensity ratios of 0.82 as the optimal threshold. [17] Although the diagnostic performance of quantitative MRI measurement is higher than that of dualenergy CT in current research, the longer examination time of MRI and contraindications such as intrareceptor implants and life support devices limit its application.…”

Section: Discussionmentioning

confidence: 99%

Value of third-generation of VNCa dual-energy CT for differentiating diffuse marrow infiltration of multiple myeloma from red bone marrow

Wang,

Zhou,

Zhang

et al. 2024

Medicine

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This study aims to investigate the ability of bone marrow imaging using third-generation dual-energy computed tomography (CT) virtual noncalcium (VNCa) to differentiate between multiple myeloma (MM) with diffuse bone marrow infiltration and red bone marrow (RBM). Bone marrow aspiration or follow-up results were used as reference. We retrospectively reviewed 188 regions of interests (ROIs) from 21 patients with confirmed MM and diffuse bone marrow infiltrations who underwent VNCa bone marrow imaging between May 2019 and September 2022. At the same time, we obtained 98 ROIs from 11 subjects with RBM for comparative study, and 189 ROIs from 20 subjects with normal yellow bone marrow for the control group. The ROIs were delineated by 2 radiologists independently, the interobservers reproducibility was evaluated by interclass correlation coefficients. The correlation with MRI grade results was analyzed by Spearman correlation coefficient. Receiver operating characteristic (ROC) curve analysis was used to determine the optimal threshold for differentiating between these groups and to assess diagnostic performance. There were statistically significant differences in VNCa CT values of bone marrow among the MM, RBM, and control groups (all P < .001), with values decreasing sequentially. A strong positive rank correlation was observed between normal bone marrow, subgroup MM with moderately and severe bone marrow infiltration divided by MRI and their corresponding CT values (ρ = 0.897, 95%CI: 0.822 to 0.942, P < .001). When the CT value of VNCa bone marrow was 7.15 HU, the area under the curve (AUC) value for differentiating RBM and MM was 0.723, with a sensitivity of 50.5% and a specificity of 89.8%. When distinguishing severe bone marrow infiltration of MM from RBM, the AUC value was 0.80 with a sensitivity 70.9% and a specificity 78.9%. The AUC values for MM, RBM, and the combined group compared to the control group were all >0.99, with all diagnostic sensitivity and specificity exceeding 95%. VNCa bone marrow imaging using third-generation dual-energy CT accurately differentiates MM lesions from normal bone marrow or RBM. It demonstrates superior diagnostic performance in distinguishing RBM from MM with diffuse bone marrow infiltration.

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Section: Discussionmentioning

confidence: 99%

Value of third-generation of VNCa dual-energy CT for differentiating diffuse marrow infiltration of multiple myeloma from red bone marrow

Wang,

Zhou,

Zhang

et al. 2024

Medicine

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“…The bone marrow of the femoral shafts is yellow marrow, with more fat. The ilia has red marrow, with less fat [26][27][28]. The bone marrow cavity space of the third lumbar vertebra is the largest among the three.…”

Section: Discussionmentioning

confidence: 99%

Quantitative evaluation of myelosuppression after chemotherapy for patients with ovarian cancer using material decomposition in dual-energy computed tomography

2023

European Journal of Gynaecological Oncology

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Objective: To demonstrate feasibility of quantifying myelosuppression after chemother-apy for patients with ovarian cancer (OC) using fat density measurement on material decomposition (MD) images in dual-energy computed tomography (DECT). Materials and methods: Fifty-seven patients with OC after chemotherapy underwent DECT. MD using fat and hydroxyapatite (HAP) as basis material pair was performed. Regions of interest (ROIs) of 20 mm2 were placed on bone marrow of ilia and femoral shafts bilaterally at level of coronal hip joint and the third sagittal lumbar vertebra to measure fat density on FAT (HAP) MD images. Eight characteristics (age, pathological type, International Federation of Gynaecology and Obstetrics (FIGO) stage, unilateral/bilateral, chemotherapy protocol and cycle, days after therapy (DAT), and ROI location) were recorded. Fat densities in ilia and femoral shafts were compared bilaterally with paired sample t tests and among 3 ROI locations with Kruskal-Wallis tests. Regression and correlations were made between fat density and 8 characteristics. Regression equations, correlation coefficients, scatterplot and normal probability plot (P-P) are provided. Results: There were no statistically significant differences in fat density in ilia or femoral shafts bilaterally (p > 0.05). Average fat densities were significantly different with 916.93 ± 9.3 in ilia, 927.04 ± 11.86 in femoral shaft, and 932.18 ± 8.45 in lumbar vertebra (p < 0.001). Regression equation was Y = 923.26 − 0.29 × age + 0.05 × pathological-type − 0.94 × FIGO stage + 0.82 × unilateral/bilateral − 0.54 × chemotherapy-protocol + 0.52 × chemotherapy-cycle + 0.01 × DAT + 7.63 × ROI location, with correlation coefficients with age, DAT and ROI location at −0.23, 0.16 and 0.53, respectively (p < 0.05). Conclusions: Myelosuppression after chemotherapy manifests as fat substitute and can be quantified by measuring fat density on FAT (HAP) images. Fat density was significantly correlated with patient age, DAT and measurement locations.

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“…Conventional MR imaging of suspected bone tumors is prudently complemented by employment of chemical shift or Dixon imaging. 12,13 The latter helps distinguish hyperplastic red marrow from the ominous bone tumor by exhibiting significant loss of signal on the opposed-phase imaging in the benign marrow hyperplasia. DWI is additionally helpful in rendering bone lesions conspicuous due to excellent background suppression, differentiates red marrow (less hyperintense on DWI with T2-shine through effect) from a significant bone lesion (more hyperintense on DWI with significant ADC restriction), and aids in the quantification of abnormality, e.g.…”

Section: Dwi Of Bone Tumorsmentioning

confidence: 99%

Diffusion-weighted MR imaging of musculoskeletal tissues: incremental role over conventional MR imaging in bone, soft tissue, and nerve lesions

et al. 2022

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Diffusion-weighted imaging (DWI) is increasingly becoming popular in musculoskeletal radiology for its incremental role over conventional MR imaging in the diagnostic strategy and assessment of therapeutic response of bone and soft tissue lesions. This article discusses the technical considerations of DWI, how to optimize its performance, and outlines the role of this novel imaging in the identification and characterization of musculoskeletal lesions, such as bone and soft tissue tumors, musculoskeletal infections, arthritis, myopathy, and peripheral neuropathy. The readers can use the newly learned concepts from the presented material containing illustrated case examples to enhance their musculoskeletal imaging and interventional practices and optimize patient management, their prognosis, and outcomes.

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Advanced MR imaging of bone marrow: quantification of signal alterations on T1-weighted Dixon and T2-weighted Dixon sequences in red marrow, yellow marrow, and pathologic marrow lesions

Cited by 18 publications

References 15 publications

Value of third-generation of VNCa dual-energy CT for differentiating diffuse marrow infiltration of multiple myeloma from red bone marrow

Value of third-generation of VNCa dual-energy CT for differentiating diffuse marrow infiltration of multiple myeloma from red bone marrow

Quantitative evaluation of myelosuppression after chemotherapy for patients with ovarian cancer using material decomposition in dual-energy computed tomography

Diffusion-weighted MR imaging of musculoskeletal tissues: incremental role over conventional MR imaging in bone, soft tissue, and nerve lesions

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