Whole-body bone marrow DWI correlates with age, anemia, and hematopoietic activity

Tsujikawa, Tetsuya; Tasaki, Toshiki; Hosono, Naoko; Tsuyoshi, Hideaki; Yoshida, Yoshio; Yamauchi, Takahiro; Kimura, Hirohiko; Okazawa, Hidehiko

doi:10.1016/j.ejrad.2019.07.022

Cited by 13 publications

(28 citation statements)

References 28 publications

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“…Lumbar and pelvic fat contents (PDFF) increased with age ( Fig. 2D) and the result was consistent with the latest reports of Schmeel et al and ours 4,7 . RDW was a predominant factor influencing bone-marrow DWI signals of pelvis and ribs ( Table 2).…”

Section: Correlation Between Bone-marrow Suv and Mr Featuressupporting

confidence: 92%

“…RDW is a measure of the range of variations in RBC volumes and can offer an indirect measure of the erythropoietic activity of red bone marrow. As described in our recent report 7 , age, Hb, and RDW are the predominant predictors for bone-marrow signals on DWI. High bone-marrow signals on DWI are related to young age, anemia, and high RDW (anemia-responsive erythropoiesis).…”

Section: Correlation Between Bone-marrow Suv and Mr Featuressupporting

confidence: 61%

“…Therefore, physiological factors influencing bone-marrow [ 18 F]FDG uptake and MR signals and the associations should be clarified for accurate diagnosis. We recently reported that age, hemoglobin (Hb), and the red cell distribution width (RDW) are the predominant predictors of bone-marrow signals on DWI 7 . A lower ADC and higher visibility of bone-marrow DWI were associated with a younger age, anemia, and increased erythropoietic activity (higher RDW).…”

Section: Snrmentioning

confidence: 99%

“…We retrospectively reviewed the medical records of all tumor patients who underwent whole-body PET/MRI with [ 18 F]FDG in our institute between February 2017 and August 2018. Patients were eligible for the study if they fulfilled the following criteria: (1) whole-body DWI, ADC, PDFF, and R2* maps were obtained, (2) CBC and CRP data measured within one week of the scan were available, and (3) normal renal function was confirmed 7 . Normal renal function is defined as an estimated glomerular filtration rate of (eGFR) > 50 mL/min/1.73 m 2 ; this condition is necessary because renal insufficiency is associated with impaired erythropoietic response to anemia.…”

Section: Snrmentioning

confidence: 99%

“…PET and MR images were transferred to the GE workstation (AW 4.6) and evaluated with matched spatial registration. Circular regions of interest (ROIs) with a fixed diameter of 20 mm were placed on lumbar vertebrae (L3-5) and bilateral posterior iliac crest 7 (Fig. 1).…”

Section: Whole-body Pet/mri Pet Scan and Dixon-based Mr-ac Patientsmentioning

confidence: 99%

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Integrated [18F]FDG PET/MRI demonstrates the iron-related bone-marrow physiology

Tsujikawa

Tasaki

Hosono

et al. 2020

Sci Rep

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We identified predictors for bone-marrow [ 18 f]fDG uptake and MR signals among complete blood count, C-reactive protein (CRP), and anthropometric factors, and demonstrated the bone-marrow physiology using integrated [ 18 F]FDG-PET/MRI. 174 oncology patients without bone-marrow lesions underwent whole-body [ 18 F]FDG-PET/MRI. The standardized uptake value (SUV), apparent diffusion coefficient (ADC), proton density fat-fraction (PDFF), and a reciprocal of T2* relaxation time (R2*) were measured in lumbar vertebrae (L3-5) and bilateral ilia. Vertebrae, pelvis, and ribs were evaluated by 3-point visual scoring on DWI. The association of the PET/MR features with the predictors was examined. Multi-regression analyses identified CRP as the strongest predictor for lumbar and iliac SUVs (standardized coefficient: β = 0.31 and β = 0.38, respectively), and for lumbar and iliac R2* (β = 0.31 and β = 0.46, respectively). In contrast, age was the strongest factor influencing lumbar and iliac ADCs (β = 0.23 and β = 0.21, respectively), and lumbar and iliac PDFFs (β = 0.53 and β = 0.54, respectively). Regarding DWI-visual scores, age was the strongest predictor for vertebrae (β = − 0.47), and the red cell distribution width (RDW) was the strongest predictor for pelvis and ribs (β = 0.33 and β = 0.47, respectively). The bone-marrow [ 18 F]FDG uptake and R2* reflect anemia of inflammation (increased granulopoiesis and reduced iron metabolism), whereas bone-marrow DWI and PDFF reflect age and anemia-responsive erythropoiesis. Abbreviations [ 18 F]FDG 2-[ 18 F]-fluoro-2-deoxy-D-glucose PDFF Proton density fat fraction R2* Reciprocal of the T2* relaxation time Hb Hemoglobin RDW Red cell distribution width WBC White blood cell CRP C-reactive protein GCSF Granulocyte colony-stimulating factor CBC Complete blood count eGFR Estimated glomerular filtration rate MR-AC Magnetic resonance based attenuation correction OSEM Ordered subset expectation maximization SUV Standardized uptake value EPI Echoplanar imaging STIR Short inversion time inversion recovery SSRF Spectral-spatial radiofrequency

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Section: Correlation Between Bone-marrow Suv and Mr Featuressupporting

confidence: 92%

Section: Correlation Between Bone-marrow Suv and Mr Featuressupporting

confidence: 61%