Measurement of fat content in vertebral marrow using a modified dixon sequence to differentiate benign from malignant processes

Yoo, Hye Jin; Hong, Sung Hwan; Kim, Dong Hyun; Choi, Ja Young; Chae, Hee Dong; Jeong, Bo Mi; Ahn, Joong Mo; Kang, Heung Sik

doi:10.1002/jmri.25496

Cited by 69 publications

(54 citation statements)

References 38 publications

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“…129,130 It has also recently been shown that the fat fraction based on chemical-shift encoding-based water-fat imaging could be used to allow a distinction between benign and malignant causes of focal bone marrow abnormalities when difficulty in the qualitative interpretation of conventional MR image arises. 131 DIFFUSION. Diffusivity is reduced in tissue with a high cellularity, e.g.…”

Section: Metabolic Diseasesmentioning

confidence: 99%

Quantitative MRI and spectroscopy of bone marrow

Karampinos

Ruschke

Dieckmeyer

et al. 2017

Magnetic Resonance Imaging

208

241

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Bone marrow is one of the largest organs in the human body, enclosing adipocytes, hematopoietic stem cells, which are responsible for blood cell production, and mesenchymal stem cells, which are responsible for the production of adipocytes and bone cells. Magnetic resonance imaging (MRI) is the ideal imaging modality to monitor bone marrow changes in healthy and pathological states, thanks to its inherent rich soft‐tissue contrast. Quantitative bone marrow MRI and magnetic resonance spectroscopy (MRS) techniques have been also developed in order to quantify changes in bone marrow water–fat composition, cellularity and perfusion in different pathologies, and to assist in understanding the role of bone marrow in the pathophysiology of systemic diseases (e.g. osteoporosis). The present review summarizes a large selection of studies published until March 2017 in proton‐based quantitative MRI and MRS of bone marrow. Some basic knowledge about bone marrow anatomy and physiology is first reviewed. The most important technical aspects of quantitative MR methods measuring bone marrow water–fat composition, fatty acid composition, perfusion, and diffusion are then described. Finally, previous MR studies are reviewed on the application of quantitative MR techniques in both healthy aging and diseased bone marrow affected by osteoporosis, fractures, metabolic diseases, multiple myeloma, and bone metastases. Level of Evidence: 3 Technical Efficacy: Stage 2J. Magn. Reson. Imaging 2018;47:332–353.

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Section: Metabolic Diseasesmentioning

confidence: 99%

Quantitative MRI and spectroscopy of bone marrow

Karampinos

Ruschke

Dieckmeyer

et al. 2017

Magnetic Resonance Imaging

208

241

View full text Add to dashboard Cite

show abstract

“…THE PROPORTION of bone marrow adipose tissue is thought to be related to the strength and remodeling capacity of the bone, and quantitative changes in the bone marrow fat fraction have been examined in various pathologic states: first, bone marrow adiposity has been found to correlate with the bone loss pathophysiology in the course of osteoporosis and to increase the fracture risk in metabolic diseases such as diabetes mellitus . Second, bone marrow adipose tissue has been shown to be replaced by malignant bone marrow processes, potentially providing a diagnostic instrument for the differentiation of benign and malignant bone marrow lesions . Third, increased bone marrow fat fractions have been observed in patients with malignant disease and a positive treatment response to both chemotherapy and radiation .…”

mentioning

confidence: 99%

“…2 Second, bone marrow adipose tissue has been shown to be replaced by malignant bone marrow processes, potentially providing a diagnostic instrument for the differentiation of benign and malignant bone marrow lesions. [3][4][5] Third, increased bone marrow fat fractions have been observed in patients with malignant disease and a positive treatment response to both chemotherapy and radiation. [6][7][8] Therefore, bone marrow fat quantification holds considerable potential for diagnosing and monitoring of disease, and can help to provide further insight into bone pathology and its relation with bone marrow adipogenesis.…”

mentioning

confidence: 99%

Proton density fat fraction MRI of vertebral bone marrow: Accuracy, repeatability, and reproducibility among readers, field strengths, and imaging platforms

Schmeel

Vomweg²,

Träber

et al. 2019

Magnetic Resonance Imaging

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Background Chemical shift‐encoding based water‐fat MRI is an emerging method to noninvasively assess proton density fat fraction (PDFF), a promising quantitative imaging biomarker for estimating tissue fat concentration. However, in vivo validation of PDFF is still lacking for bone marrow applications. Purpose To determine the accuracy and precision of MRI‐determined vertebral bone marrow PDFF among different readers and across different field strengths and imager manufacturers. Study Type Repeatability/reproducibility. Subjects Twenty‐four adult volunteers underwent lumbar spine MRI with one 1.5T and two different 3.0T MR scanners from two vendors on the same day. Field Strength/Sequence 1.5T and 3.0T/3D spoiled‐gradient echo multipoint Dixon sequences. Assessment Two independent readers measured intravertebral PDFF for the three most central slices of the L1–5 vertebral bodies. Single‐voxel MR spectroscopy (MRS)‐determined PDFF served as the reference standard for PDFF estimation. Statistical Tests Accuracy and bias were assessed by Pearson correlation, linear regression analysis, and Bland–Altman plots. Repeatability and reproducibility were evaluated by Wilcoxon signed rank test, Friedman test, and coefficients of variation. Intraclass correlation coefficients were used to validate intra‐ and interreader as well as intraimager agreements. Results MRI‐based PDFF estimates of lumbar bone marrow were highly correlated (r2 = 0.899) and accurate (mean bias, –0.6%) against the MRS‐determined PDFF reference standard. PDFF showed high linearity (r2 = 0.972–0.978) and small mean bias (0.6–1.5%) with 95% limits of agreement within ±3.4% across field strengths, imaging platforms, and readers. Repeatability and reproducibility of PDFF were high, with the mean overall coefficient of variation being 0.86% and 2.77%, respectively. The overall intraclass correlation coefficient was 0.986 as a measure for an excellent interreader agreement. Data Conclusion MRI‐based quantification of vertebral bone marrow PDFF is highly accurate, repeatable, and reproducible among readers, field strengths, and MRI platforms, indicating its robustness as a quantitative imaging biomarker for multicentric studies. Level of Evidence: 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:1762–1772.

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“…In the post-processing of the in-phase and out-ofphase images, there is a step for water and fat separation, so that adding the in-phase and out-of-phase images results in a water image, while subtracting the out-of-phase image from the in-phase image gives a fat image (1) . Thus, the Dixon technique allows the measurement of the fatwater fraction in a region of interest larger than that achieved with spectroscopy and with higher spatial resolution (1,13,15,16) . In general, this concept could be used for the suppression or quantification of fat in various types of pulse sequences (14) .…”

Section: Basic Physical Principlesmentioning

confidence: 99%

“…Many variants of the Dixon technique have been developed, providing more consistent separation of fat and water signals, as well as allowing correction for many confounding factors (15) . The development of the technique has shown that symmetrically acquired echoes can produce artifacts that can degrade image quality.…”

Section: Basic Physical Principlesmentioning

confidence: 99%

Applications of the Dixon technique in the evaluation of the musculoskeletal system

2021

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The acquisition of images with suppression of the fat signal is very useful in clinical practice and can be achieved in a variety of sequences. The Dixon technique, unlike other fat suppression techniques, allows the signal of fat to be suppressed in the postprocessing rather than during acquisition, as well as allowing the visualization of maps showing the distribution of water and fat. This review of the Dixon technique aims to illustrate the basic physical principles, to compare the technique with other magnetic resonance imaging sequences for fat suppression or fat quantification, and to describe its applications in the study of diseases of the musculoskeletal system. Many variants of the Dixon technique have been developed, providing more consistent separation of the fat and water signals, as well as allowing correction for many confounding factors. It allows homogeneous fat suppression, being able to be acquired in combination with several other sequences, as well as with different weightings. The technique also makes it possible to obtain images with and without fat suppression from a single acquisition. In addition, the Dixon technique can be used as a quantitative method, allowing the proportion of tissue fat to be determined, and, in more updated versions, can quantify tissue iron.

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Measurement of fat content in vertebral marrow using a modified dixon sequence to differentiate benign from malignant processes

Abstract: 3 J. MAGN. RESON. IMAGING 2017;45:1534-1544.

Cited by 69 publications

References 38 publications

Quantitative MRI and spectroscopy of bone marrow

Quantitative MRI and spectroscopy of bone marrow

Proton density fat fraction MRI of vertebral bone marrow: Accuracy, repeatability, and reproducibility among readers, field strengths, and imaging platforms

Applications of the Dixon technique in the evaluation of the musculoskeletal system

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