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Whole-body MRI, dynamic contrast-enhanced MRI, and diffusion-weighted imaging for the staging of multiple myeloma. Skeletal Radiol 2017; 46:733-750. [PMID: 28289855 DOI: 10.1007/s00256-017-2609-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 02/07/2017] [Accepted: 02/13/2017] [Indexed: 02/02/2023]
Abstract
Magnetic resonance imaging (MRI) is the most sensitive imaging technique for the detection of bone marrow infiltration, and has therefore recently been included in the new diagnostic myeloma criteria, as proposed by the International Myeloma Working Group. Nevertheless, conventional MRI only provides anatomical information and is therefore only of limited use in the response assessment of patients with multiple myeloma. The additional information from functional MRI techniques, such as diffusion-weighted imaging and dynamic contrast-enhanced MRI, can improve the detection rate of bone marrow infiltration and the assessment of response. This can further enhance the sensitivity and specificity of MRI in the staging of multiple myeloma patients. This article provides an overview of the technical aspects of conventional and functional MRI techniques with practical recommendations. It reviews the diagnostic performance, prognostic value, and role in therapy assessment in multiple myeloma and its precursor stages.
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Toslak IE, Cekic B, Turk A, Eraslan A, Parlak AE. Evaluation of Diffusion-weighted MR Imaging as a Technique for Detecting Bone Marrow Edema in Patients with Osteitis Pubis. Magn Reson Med Sci 2017; 16:317-324. [PMID: 28190854 PMCID: PMC5743523 DOI: 10.2463/mrms.mp.2016-0104] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose: Our aims were to determine the feasibility of diffusion-weighted magnetic resonance imaging (DWI) in the detection of bone marrow edema (BME) and explore the apparent diffusion coefficient (ADC) alterations in patients with osteitis pubis (OP). Materials and Methods: 42 consecutive patients clinically suspected to have athletic pubalgia and 31 control subjects were enrolled in the study. All subjects underwent diagnostic focused magnetic resonance imaging (MRI) and DWI at b values of 0 and 600 s/mm2. Two radiologists reviewed the images for the presence of active OP. The presence of subchondral BME and contrast enhancement were considered to indicate active OP. ADC values were measured from public bodies of both groups. DWI results were correlated with routine MRI findings. Receiver-operating-characteristic curves were formed. Cut-off values for ADC, sensitivity and specificity values were measured. Results: 36/42 (85%) of the cases had BME/enhancement on routine MRIs and identified as active OP. ADC measurements of the patients were greater than the controls (P < 0.05). For the optimal cut-off values DWI showed sensitivity and specificity values of 97.3%, and 90.3%, for the right, and 97.1%, and 96.7% for the left side, respectively (Area under the curve 0.965 and 0.973). Intra-and inter-rater reliability for readers were substantial-perfect for all sessions. Conclusion: DWI is fast, accurate, and highly reproducible technique for the detection of BME in patients with active OP. It allows distinct bone marrow contrast without the use of gadolinium contrast, increases visual perception of active lesions, gives objective information by quantifying the diffusion coefficients, thus increase diagnostic confidence. We suggest the use of DWI as a cost-effective adjunctive tool for the diagnosis of active OP particularly in early cases and inconclusive diagnostic MRI. Future studies are necessary to determine the utility of DWI to evaluate severity of the disease and treatment response before returning athletes to play.
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Affiliation(s)
| | - Bulent Cekic
- Department of Radiology, Antalya Training and Research Hospital
| | - Aysen Turk
- Department of Sports Medicine, Antalya Training and Research Hospital
| | - Ali Eraslan
- Department of Sports Medicine, Antalya Training and Research Hospital
| | - A Eda Parlak
- Department of Radiology, Antalya Training and Research Hospital
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Dieckmeyer M, Ruschke S, Eggers H, Kooijman H, Rummeny EJ, Kirschke JS, Baum T, Karampinos DC. ADC Quantification of the Vertebral Bone Marrow Water Component: Removing the Confounding Effect of Residual Fat. Magn Reson Med 2016; 78:1432-1441. [DOI: 10.1002/mrm.26550] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 10/05/2016] [Accepted: 10/18/2016] [Indexed: 12/16/2022]
Affiliation(s)
- Michael Dieckmeyer
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar; Technische Universität München; Munich Germany
| | - Stefan Ruschke
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar; Technische Universität München; Munich Germany
| | | | | | - Ernst J. Rummeny
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar; Technische Universität München; Munich Germany
| | - Jan S. Kirschke
- Section of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar; Technische Universität München; Munich Germany
| | - Thomas Baum
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar; Technische Universität München; Munich Germany
| | - Dimitrios C. Karampinos
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar; Technische Universität München; Munich Germany
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Taouli B, Beer AJ, Chenevert T, Collins D, Lehman C, Matos C, Padhani AR, Rosenkrantz AB, Shukla-Dave A, Sigmund E, Tanenbaum L, Thoeny H, Thomassin-Naggara I, Barbieri S, Corcuera-Solano I, Orton M, Partridge SC, Koh DM. Diffusion-weighted imaging outside the brain: Consensus statement from an ISMRM-sponsored workshop. J Magn Reson Imaging 2016; 44:521-40. [PMID: 26892827 PMCID: PMC4983499 DOI: 10.1002/jmri.25196] [Citation(s) in RCA: 127] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 01/28/2016] [Accepted: 01/30/2016] [Indexed: 12/11/2022] Open
Abstract
The significant advances in magnetic resonance imaging (MRI) hardware and software, sequence design, and postprocessing methods have made diffusion-weighted imaging (DWI) an important part of body MRI protocols and have fueled extensive research on quantitative diffusion outside the brain, particularly in the oncologic setting. In this review, we summarize the most up-to-date information on DWI acquisition and clinical applications outside the brain, as discussed in an ISMRM-sponsored symposium held in April 2015. We first introduce recent advances in acquisition, processing, and quality control; then review scientific evidence in major organ systems; and finally describe future directions. J. Magn. Reson. Imaging 2016;44:521-540.
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Affiliation(s)
- Bachir Taouli
- Department of Radiology and Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Ambros J. Beer
- Department of Nuclear Medicine, University Hospital Ulm, Ulm, Germany
| | - Thomas Chenevert
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - David Collins
- CR UK Cancer Imaging Centre, Institute of Cancer Research and Department of Radiology, Royal Marsden Hospital, London, UK
| | - Constance Lehman
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Celso Matos
- Department of Radiology, Champalimaud Clinical Centre, Lisbon, Portugal
| | | | | | - Amita Shukla-Dave
- Departments of Medical Physics and Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
| | - Eric Sigmund
- Irene and Bernard Schwartz Center for Biomedical Imaging (CBI) and Center for Advanced Imaging and Innovation (CAIR), Department of Radiology, NYU Langone Medical Center, New York, New York, USA
| | - Lawrence Tanenbaum
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Harriet Thoeny
- Department of Diagnostic Radiology, Inselspital Bern, Bern, Switzerland
| | | | | | - Idoia Corcuera-Solano
- Department of Radiology and Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Matthew Orton
- CR UK Cancer Imaging Centre, Institute of Cancer Research and Department of Radiology, Royal Marsden Hospital, London, UK
| | | | - Dow-Mu Koh
- Institute of Cancer Research and Department of Radiology, Royal Marsden Hospital, London, UK
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Keller S, Ittrich H, Schramm C, Lohse AW, Amling M, Adam G, Yamamura J. Diffusion-weighted MRI for detection of hepatic osteodystrophy in primary sclerosing cholangitis: a comparison study with dual-energy X-ray absorptiometry. Jpn J Radiol 2016; 34:677-683. [PMID: 27492220 DOI: 10.1007/s11604-016-0573-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 07/27/2016] [Indexed: 12/19/2022]
Abstract
PURPOSE Osteodystrophy is a frequent complication in primary sclerosing cholangitis (PSC). The aim was to test the feasibility of vertebral bone diffusion-weighted imaging (DWI) in routine liver MRI for detection of osteoporosis using dual-energy X-ray absorptiometry (DXA) as gold standard. MATERIALS AND METHODS Forty PSC patients (50 ± 12.6 years) and ten controls (49.5 ± 13.0 years) were scanned using a DWI spin echo echo-planar sequence (b-factors 0-800 s/mm2) on a 3-T MRI system and DXA (76 kVp). The apparent diffusion coefficient (ADC) and T-score were correlated to laboratory and clinical details using Pearson correlation. RESULTS In DXA-diagnosed osteoporosis (n = 3) and osteopenia (n = 12), the mean ADC was decreased (0.26 ± 0.03 and 0.30 ± 0.07 × 10-3 mm2/s) compared to patients with normal DXA scan results (n = 25; 0.32 ± 0.06 × 10-3 mm2/s). No significant correlation of the ADC and T-score (r = 0.24; p = 0.13) was found, but the T-score correlated significantly to disease duration (r = -0.33; p = 0.04). In patients with prednisolone therapy (n = 7), the DXA T-score was significantly lower (-1.46 ± 0.49 vs. -0.16 ± 0.23; p = 0.03). CONCLUSION Diffusion-weighted MRI of the vertebral spine is a feasible technic to detect diffusion alterations caused by osteoporosis but lacks diagnostic capacities for diagnosing minor reductions of the bone mineral density detected by DXA.
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Affiliation(s)
- Sarah Keller
- Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Germany.
| | - Harald Ittrich
- Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Germany
| | - Christoph Schramm
- Department of Internal Medicine, University Medical Center Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Germany
| | - Ansgar W Lohse
- Department of Internal Medicine, University Medical Center Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Germany
| | - Michael Amling
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Germany
| | - Gerhard Adam
- Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Germany
| | - Jin Yamamura
- Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Germany
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