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Ogon I, Takebayashi T, Takashima H, Abe Y, Oguma H, Imamura R, Akatsuka Y, Morita T, Teramoto A. Intravoxel Incoherent Motion Factors Affecting Collapse and Nonunion of Osteoporotic Vertebral Fracture. Global Spine J 2024; 14:2074-2080. [PMID: 37001146 DOI: 10.1177/21925682231167788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/19/2023] Open
Abstract
STUDY DESIGN Longitudinal study. OBJECTIVES Intravoxel incoherent motion (IVIM), a magnetic resonance imaging (MRI) scanning technique that applies diffusion-weighted imaging (DWI), is effective for the quantitative assessment of malignant tumors of the vertebral bone. We hypothesized that IVIM parameters of vertebral bodies are associated with the prognosis of osteoporotic vertebral fracture (OVF). We aimed to explore the relationships between IVIM parameters for vertebral collapse and non-union after OVF and calculate the cut-off values of these parameters for vertebral collapse and non-union. METHODS A total of 150 patients with acute OVF (150 women; mean age: 79.1 ± 7.4 years) were included and treated conservatively with bracing. MRI was performed at the time of injury. IVIM parameters, such as apparent diffusion coefficient (ADC), molecular diffusion coefficient (D), and perfusion-related diffusion (D*) were recorded. The patients were classified into 3 groups: low-collapse (height loss of ≤50%), high-collapse (height loss of >50%), and non-union. We compared ADC, D, and D* among the low-collapse, high-collapse, and non-union groups and performed a receiver operating characteristic (ROC) curve analysis to determine the boundary values of the high-collapse and non-union groups. RESULTS The low-collapse, high-collapse, and non-union groups had no significant differences in ADC and D. However, D* differed significantly among the 3 groups. ROC analysis revealed cut-off values of 19.0 × 10-3 mm2/s and 12.3 × 10-3 mm2/s for the high-collapse and non-union groups, respectively. CONCLUSIONS D* is a significant prognostic indicator for high-collapse and non-union groups with OVF. This suggests that D* should be considered when assessing OVF.
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Affiliation(s)
- Izaya Ogon
- Department of Orthopaedic Surgery, Sapporo Medical University, School of Medicine, Sapporo, Japan
| | - Tsuneo Takebayashi
- Department of Orthopaedic Surgery, Sapporo Maruyama Orthopaedic Hospital, Sapporo, Japan
| | | | - Yasuhisa Abe
- Department of Orthopaedic Surgery, Sapporo Maruyama Orthopaedic Hospital, Sapporo, Japan
| | - Hiroshi Oguma
- Department of Orthopaedic Surgery, Sapporo Maruyama Orthopaedic Hospital, Sapporo, Japan
| | - Rui Imamura
- Department of Orthopaedic Surgery, Sapporo Medical University, School of Medicine, Sapporo, Japan
| | - Yoshihiro Akatsuka
- Department of Orthopaedic Surgery, Sapporo Medical University, School of Medicine, Sapporo, Japan
| | - Tomonori Morita
- Department of Orthopaedic Surgery, Sapporo Medical University, School of Medicine, Sapporo, Japan
| | - Atsushi Teramoto
- Department of Orthopaedic Surgery, Sapporo Medical University, School of Medicine, Sapporo, Japan
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Buko EO, Bhave S, Moeller S, Laine JC, Tóth F, Johnson CP. Intravoxel incoherent motion (IVIM) detects femoral head ischemia in a piglet model of Legg-Calvé-Perthes disease. J Orthop Res 2024; 42:855-863. [PMID: 37971281 PMCID: PMC10978300 DOI: 10.1002/jor.25733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 09/11/2023] [Accepted: 11/14/2023] [Indexed: 11/19/2023]
Abstract
There is a clinical need for alternatives to gadolinium contrast-enhanced magnetic resonance imaging (MRI) to facilitate early detection and assessment of femoral head ischemia in pediatric patients with Legg-Calvé-Perthes disease (LCPD), a juvenile form of idiopathic osteonecrosis of the femoral head. The purpose of this study was to determine if intravoxel incoherent motion (IVIM), a noncontrast-enhanced MRI method to simultaneously measure tissue perfusion and diffusion, can detect femoral head ischemia using a piglet model of LCPD. Twelve 6-week-old piglets underwent unilateral hip surgery to induce complete femoral head ischemia. The unoperated, contralateral femoral head served as a perfused control. The bilateral hips of the piglets were imaged in vivo at 3T MRI using IVIM and contrast-enhanced MRI 1 week after surgery. Median apparent diffusion coefficient (ADC) and IVIM parameters (diffusion coefficient: Ds; perfusion coefficient: Df; perfusion fraction: f; and perfusion flux: f*Df) were compared between regions of interest comprising the epiphyseal bone marrow of the ischemic and control femoral heads. Contrast-enhanced MRI confirmed complete femoral head ischemia in 11/12 piglets. IVIM perfusion fraction (f) and flux (f*Df) were significantly decreased in the ischemic versus control femoral heads: on average, f decreased 47 ± 27% (Δf = -0.055 ± 0.034; p = 0.0003) and f*Df decreased 50 ± 27% (Δf*Df = -0.59 ± 0.49 × 10-3 mm2/s; p = 0.0026). In contrast, IVIM diffusion coefficient (Ds) and ADC were significantly increased in the ischemic versus control femoral heads: on average, Ds increased 78 ± 21% (ΔDs = 0.60 ± 0.14 × 10-3 mm2/s; p < 0.0001) and ADC increased 60 ± 36% (ΔADC = 0.50 ± 0.23 × 10-3 mm2/s; p < 0.0001). In conclusion, IVIM is sensitive in detecting bone marrow ischemia in a piglet model of LCPD.
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Affiliation(s)
- Erick O. Buko
- Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul, MN
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN
| | - Sampada Bhave
- Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul, MN
| | - Steen Moeller
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN
| | - Jennifer C. Laine
- Gillette Children’s Specialty Healthcare, St. Paul, MN
- Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN
| | - Ferenc Tóth
- Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul, MN
| | - Casey P. Johnson
- Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul, MN
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN
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Liu J, Karfoul A, Marage L, Shu H, Gambarota G. Estimation of intravoxel incoherent motion (IVIM) parameters in vertebral bone marrow: a comparative study of five algorithms. MAGMA (NEW YORK, N.Y.) 2023; 36:837-847. [PMID: 36715885 DOI: 10.1007/s10334-023-01064-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 01/15/2023] [Accepted: 01/16/2023] [Indexed: 01/31/2023]
Abstract
OBJECTIVES To access the performances of different algorithms for quantification of Intravoxel incoherent motion (IVIM) parameters D, f, [Formula: see text] in Vertebral Bone Marrow (VBM). MATERIALS AND METHODS Five algorithms were studied: four deterministic algorithms (the One-Step and three segmented methods: Two-Step, Three-Step, and Fixed-[Formula: see text] algorithm) based on the least-squares (LSQ) method and a Bayesian probabilistic algorithm. Numerical simulations and quantification of IVIM parameters D, f, [Formula: see text] in vivo in vertebral bone marrow, were done on six healthy volunteers. The One-way repeated-measures analysis of variance (ANOVA) followed by Bonferroni's multiple comparison test (p value = 0.05) was applied. RESULTS In numerical simulations, the Bayesian algorithm provided the best estimation of D, f, [Formula: see text] compared to the deterministic algorithms. In vivo VBM-IVIM, the values of D and f estimated by the Bayesian algorithm were close to those of the One-Step method, in contrast to the three segmented methods. DISCUSSION The comparison of the five algorithms indicates that the Bayesian algorithm provides the best estimation of VBM-IVIM parameters, in both numerical simulations and in vivo data.
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Affiliation(s)
- Jie Liu
- Laboratory of Image Science and Technology (LIST), School of Computer Science and Engineering, Southeast University, Nanjing, 210096, China.
- College of Information Science and Technology, Nanjing Forestry University, Nanjing, 210037, China.
- Univ Rennes, Southeast University, INSERM, Centre de Recherche en Information Biomèdicale sino-français (CRIBs)-LIA, 35000, Rennes, France.
| | - Ahmad Karfoul
- Univ Rennes, Southeast University, INSERM, Centre de Recherche en Information Biomèdicale sino-français (CRIBs)-LIA, 35000, Rennes, France
- Univ Rennes, INSERM, LTSI-UMR 1099, 35000, Rennes, France
| | - Louis Marage
- Department of Medical Physics, Georges François Leclerc Cancer Center, 21000, Dijon, France
| | - Huazhong Shu
- Laboratory of Image Science and Technology (LIST), School of Computer Science and Engineering, Southeast University, Nanjing, 210096, China
- Univ Rennes, Southeast University, INSERM, Centre de Recherche en Information Biomèdicale sino-français (CRIBs)-LIA, 35000, Rennes, France
| | - Giulio Gambarota
- Univ Rennes, Southeast University, INSERM, Centre de Recherche en Information Biomèdicale sino-français (CRIBs)-LIA, 35000, Rennes, France
- Univ Rennes, INSERM, LTSI-UMR 1099, 35000, Rennes, France
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Differentiating atypical hemangiomas and vertebral metastases: a field-of-view (FOV) and FOCUS intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) study. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2020; 29:3187-3193. [PMID: 33078268 DOI: 10.1007/s00586-020-06632-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/15/2020] [Accepted: 10/07/2020] [Indexed: 12/20/2022]
Abstract
PURPOSE Some atypical vertebral hemangiomas (VHs) may mimic metastases on routine MRI and can result in misdiagnosis and ultimately to additional imaging, biopsy and unnecessary costs. The purpose of this study is to assess the utility of intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) on account of field-of-view optimized and constrained undistorted single shot (FOCUS) in distinguishing atypical VHs and vertebral metastases. METHODS A total of 25 patients with vertebral metastases and 25 patients with atypical VHs were confirmed by clinical follow-up or pathology. IVIM-DWI imaging was performed at different b values (0, 30, 50, 100, 150, 200, 400, 600, 800, 1000 mm2/s). IVIM parameters [the true diffusion coefficient (D), pseudodiffusion coefficient (D*), standard apparent diffusion coefficient (ADC), and perfusion fraction (f)] were calculated and compared between two groups by using Student's t test. A receiver operating characteristic analysis was performed. RESULTS Quantitative analysis of standard ADC and D parameters showed significantly lower values in vertebral metastases when compared to atypical hemangiomas [ADC value: (0.70 ± 0.12) × 10-3 mm2/s vs (1.14 ± 0.28) × 10-3 mm2/s; D value: (0.47 ± 0.07) × 10-3 mm2/s vs (0.76 ± 0.14) × 10-3 mm2/s, all P < 0.01]. The sensitivity and specificity of D value were 93.8% and 92.3%, respectively. CONCLUSION The standard ADC value and D value may be used as an indicator to distinguish vertebral metastases from atypical VHs. FOCUS IVIM-derived parameters provide potential value in the quantitatively differentiating vertebral metastases from vertebral atypical hemangiomas.
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Abstract
Although advanced quantitative imaging may not be currently used to any degree in the routine reporting of spinal examinations, this situation will change in the not too distant future. Advanced quantitative imaging has already allowed us to understand a great deal more regarding spinal development, marrow physiology, and disease pathogenesis. Radiologists are ideally suited to drive this research forward. To speed up this process and optimize the impact of studies reporting spine quantitative data, we should work toward universal standards on the acquisition of spine data that will allow quantitative studies to be more easily compared, contrasted, and amalgamated.
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Abstract
PURPOSE OF REVIEW To provide an overview on recent technical development for quantifying marrow composition using magnetic resonance imaging (MRI) and spectroscopy (MRS) techniques, as well as a summary on recent findings of interrelationship between marrow adipose tissue (MAT) and skeletal health in the context of osteoporosis. RECENT FINDINGS There have been significant technical advances in reliable quantification of marrow composition using MR techniques. Cross-sectional studies have demonstrated a negative correlation between MAT and bone, with trabecular bone associating more strongly with MAT than cortical bone. However, longitudinal studies of MAT and bone are limited. MAT contents and composition have been associated with prevalent vertebral fracture. The evidence between MAT and clinical fracture is more limited, and, to date, no studies have reported on the relationship between MAT and incident fracture. Increasing evidence suggests a dynamic role of marrow fat in skeletal health. Reliable non-invasive quantification of marrow composition will facilitate developing novel treatment strategies for osteoporosis.
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Affiliation(s)
- Xiaojuan Li
- Department of Biomedical Engineering, Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, 9500 Euclid Avenue, ND20, Cleveland, OH, 44195, USA.
| | - Ann V Schwartz
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
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