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Wang T, Zhou B, Zhang K, Yan C, Guan X. Value of third-generation of VNCa dual-energy CT for differentiating diffuse marrow infiltration of multiple myeloma from red bone marrow. Medicine (Baltimore) 2024; 103:e38003. [PMID: 38701295 PMCID: PMC11062734 DOI: 10.1097/md.0000000000038003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 04/04/2024] [Indexed: 05/05/2024] Open
Abstract
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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Affiliation(s)
- Tiantian Wang
- Department of Radiology, The Affiliated Tengzhou Hospital of Xuzhou Medical University, Tengzhou, Shandong Province, China
| | - Biao Zhou
- Department of Radiology, The Affiliated Tengzhou Hospital of Xuzhou Medical University, Tengzhou, Shandong Province, China
| | - Kui Zhang
- Department of Hematology, The Affiliated Tengzhou Hospital of Xuzhou Medical University, Tengzhou, Shandong Province, China
| | - Chen Yan
- Department of Radiology, The Affiliated Tengzhou Hospital of Xuzhou Medical University, Tengzhou, Shandong Province, China
| | - Xiangzhen Guan
- Department of Radiology, The Affiliated Tengzhou Hospital of Xuzhou Medical University, Tengzhou, Shandong Province, China
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Yan SY, Yang YW, Jiang XY, Hu S, Su YY, Yao H, Hu CH. Fat quantification: Imaging methods and clinical applications in cancer. Eur J Radiol 2023; 164:110851. [PMID: 37148843 DOI: 10.1016/j.ejrad.2023.110851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 04/19/2023] [Accepted: 04/24/2023] [Indexed: 05/08/2023]
Abstract
Recently, the study of the relationship between lipid metabolism and cancer has evolved. The characteristics of intratumoral and peritumoral fat are distinct and changeable during cancer development. Subcutaneous and visceral adipose tissue are also associated with cancer prognosis. In non-invasive imaging, fat quantification parameters such as controlled attenuation parameter, fat volume fraction, and proton density fat fraction from different imaging methods complement conventional images by providing concrete fat information. Therefore, measuring the changes of fat content for further understanding of cancer characteristics has been applied in both research and clinical settings. In this review, the authors summarize imaging advances in fat quantification and highlight their clinical applications in cancer precaution, auxiliary diagnosis and classification, therapy response monitoring, and prognosis.
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Affiliation(s)
- Suo Yu Yan
- Department of Radiology, The First Affiliated Hospital to Soochow University, Suzhou 215006, PR China
| | - Yi Wen Yang
- Department of Radiology, The First Affiliated Hospital to Soochow University, Suzhou 215006, PR China
| | - Xin Yu Jiang
- Department of Radiology, The First Affiliated Hospital to Soochow University, Suzhou 215006, PR China
| | - Su Hu
- Department of Radiology, The First Affiliated Hospital to Soochow University, Suzhou 215006, PR China
| | - Yun Yan Su
- Department of Radiology, The First Affiliated Hospital to Soochow University, Suzhou 215006, PR China.
| | - Hui Yao
- Department of Radiology, The First Affiliated Hospital to Soochow University, Suzhou 215006, PR China; Department of General Surgery, The First Affiliated Hospital to Soochow University, Suzhou 215006, PR China.
| | - Chun Hong Hu
- Department of Radiology, The First Affiliated Hospital to Soochow University, Suzhou 215006, PR China.
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Guirguis M, Sharan G, Wang J, Chhabra A. Diffusion-weighted MR imaging of musculoskeletal tissues: incremental role over conventional MR imaging in bone, soft tissue, and nerve lesions. BJR Open 2022; 4:20210077. [PMID: 36452057 PMCID: PMC9667480 DOI: 10.1259/bjro.20210077] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 01/18/2022] [Accepted: 02/24/2022] [Indexed: 11/05/2022] Open
Abstract
Diffusion-weighted imaging 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 diffusion-weighted imaging, 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 conventional musculoskeletal imaging and interventional practices and optimize patient management, their prognosis, and outcomes.
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Affiliation(s)
- Mina Guirguis
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, US
| | - Gaurav Sharan
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, US
| | | | - Avneesh Chhabra
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, US
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Bajaj G, Callan AK, Weinschenk RC, Chhabra A. Multiparametric Evaluation of Soft Tissue Sarcoma: Current Perspectives and Future Directions. Semin Roentgenol 2022; 57:212-231. [DOI: 10.1053/j.ro.2022.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/31/2022] [Accepted: 02/02/2022] [Indexed: 11/11/2022]
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3D isotropic spine echo MR imaging of elbow: How it helps surgical decisions. Eur J Radiol Open 2022; 9:100410. [PMID: 35281319 PMCID: PMC8904410 DOI: 10.1016/j.ejro.2022.100410] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 02/01/2022] [Accepted: 02/23/2022] [Indexed: 11/23/2022] Open
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Hoffman RJ, Stanborough RO, Garner HW. Diagnostic Imaging Approach to Solitary Bone Lesions. Semin Roentgenol 2022; 57:241-251. [DOI: 10.1053/j.ro.2022.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/12/2022] [Accepted: 01/16/2022] [Indexed: 11/11/2022]
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Gulati V, Chhabra A. Qualitative and Quantitative MRI Techniques for the Evaluation of Musculoskeletal Neoplasms. Semin Roentgenol 2021; 57:291-305. [DOI: 10.1053/j.ro.2021.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/12/2021] [Accepted: 11/23/2021] [Indexed: 11/11/2022]
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Ashikyan O, Wells J, Chhabra A. 3D MRI of the Hip Joint: Technical Considerations, Advantages, Applications, and Current Perspectives. Semin Musculoskelet Radiol 2021; 25:488-500. [PMID: 34547814 DOI: 10.1055/s-0041-1730910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Magnetic resonance imaging (MRI) is a common choice among various imaging modalities for the evaluation of hip conditions. Conventional MRI with two-dimensional acquisitions requires a significant amount of time and is limited by partial-volume artifacts and suboptimal fluid-to-cartilage contrast. Recent hardware and software advances have resulted in development of novel isotropic three-dimensional (3D) single-acquisition protocols that cover the volume of the entire hip and can be reconstructed in arbitrary planes for submillimeter assessment of bony and labro-cartilaginous structures in their planes of orientation. This technique facilitates superior identification of small labral tears and other hip lesions with better correlations with arthroscopy. In this review, we discuss technical details related to 3D MRI of the hip, its advantages, and its role in commonly encountered painful conditions that can be evaluated with great precision using this technology. The entities described are femoroacetabular impingement with acetabular labral tears, acetabular dysplasia, avascular necrosis, regional tendinopathies and tendon tears, bursitis, and other conditions.
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Affiliation(s)
| | - Joel Wells
- Department of Orthopedic Surgery, UT Southwestern, Dallas, Texas
| | - Avneesh Chhabra
- Department of Radiology, UT Southwestern, Dallas, Texas.,Department of Orthopedic Surgery, UT Southwestern, Dallas, Texas
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Saifuddin A, Shafiq H, Malhotra K, Santiago R, Pressney I. Comparison of in-phase and opposed-phase T1W gradient echo and T2W fast spin echo dixon chemical shift imaging for the assessment of non-neoplastic, benign neoplastic and malignant marrow lesions. Skeletal Radiol 2021; 50:1209-1218. [PMID: 33196854 DOI: 10.1007/s00256-020-03663-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 10/26/2020] [Accepted: 10/27/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The objective of this study is to compare T1-weighted gradient echo (T1W GrE: control technique) chemical shift imaging (CSI) with T2-weighted fast spin echo (T2W FSE: experimental technique) CSI for differentiating non-neoplastic and neoplastic marrow lesions. MATERIALS AND METHODS Patients undergoing MRI for various marrow lesions were investigated with T1W GrE and T2W FSE Dixon CSI. Signal intensity (SI) change between in-phase (IP) and opposed-phase (OP) sequences was calculated, and SI drop > 20% considered to represent non-neoplastic lesions while SI drop < 20% considered to represent neoplastic lesions. Final diagnosis was based on imaging features (n = 42) or histology (n = 43) and classified as non-neoplastic, benign neoplastic, and malignant neoplastic. Inter-observer and inter-technique agreement between 2 readers was calculated. RESULTS The study included 85 patients (44 males and 41 females; mean age 41.1 years, range 2-83 years). Final diagnosis included 19 (22.4%) non-neoplastic lesions, 27 (31.8%) benign neoplasms, and 39 (45.9%) malignant neoplasms. On T1W GrE CSI, 19-21 lesions were classed as non-neoplastic and 64-66 as neoplastic, while on T2W FSE Dixon CSI, 22-24 lesions were classed as non-neoplastic and 61-64 as neoplastic. Lesion classification matched between the 2 techniques in 91.8-96.5% of cases. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of T1W GrE CSI for differentiating non-neoplastic and neoplastic marrow lesions were 66.7-72.2%, 88.1-89.6%, 61.9-63.2%, 90.9-92.2%, and 84.7%, and of T2W FSE Dixon CSI were 72.2-77.8%, 85.1-86.6%, 58.3-59.1%, 92.1-93.4%, and 83.5%. CONCLUSIONS T1W GrE CSI and T2W FSE Dixon CSI produce similar results in the assessment of non-neoplastic and neoplastic marrow lesions.
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Affiliation(s)
- Asif Saifuddin
- Department of Radiology, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK
| | - Hassan Shafiq
- Department of Orthopaedics, Bart's Health NHS Trust, London, UK
| | - Karan Malhotra
- Department of Orthopaedics, Royal National Orthopaedic Hospital, Stanmore, UK
| | - Rodney Santiago
- Department of Radiology, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK
| | - Ian Pressney
- Department of Radiology, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK.
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Saifuddin A, Rajakulasingam R, Santiago R, Siddiqui M, Khoo M, Pressney I. Comparison of lumbar degenerative disc disease using conventional fast spin echo T2W MRI and T2 fast spin echo dixon sequences. Br J Radiol 2021; 94:20201438. [PMID: 33684306 DOI: 10.1259/bjr.20201438] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVES To compare the grading of lumbar degenerative disc disease (DDD), Modic end-plate changes (MEPC) and identification of high intensity zones (HIZ) on a combination of sagittal T1weighted turbo spin echo (T1W TSE), T2weighted fast spin echo (T2W FSE) and short tau inversion recovery (STIR) sequences (routine protocol) with a single sagittal T2W FSE Dixon MRI sequence which provides in-phase, opposed-phase, water only and fat only images in a single acquisition (Dixon protocol). METHODS 50 patients underwent lumbar spine MRI using the routine protocol with the addition of a T2W FSE Dixon sequence. DDD grade, MEPC and HIZ for each disc level were assessed on the routine and Dixon protocols. Each protocol was reviewed independently by three readers (consultant musculoskeletal radiologists with 26-, 8- and 4 years' experience), allowing assessment of inter-reader agreement and inter protocol agreement for each assessed variable. RESULTS The study included 17 males and 33 females (mean age 51 years; range 8-82 years). Inter-reader agreement for DDD grade on the routine protocol was 0.57 and for the Dixon protocol was 0.63 (p = 0.08). Inter-reader agreement for MEPC on the routine protocol was 0.45 and for the Dixon protocol was 0.53 (p = 0.02), and inter-reader agreement for identification of the HIZ on the routine protocol was 0.52 and for the Dixon protocol was 0.46 (p = 0.27). Intersequence agreement for DDD grade ranged from 0.61 to 0.97, for MEPC 0.46-0.62 and for HIZ 0.39-0.5. CONCLUSION A single sagittal T2W FSE Dixon MRI sequence could potentially replace the routine three sagittal sequence protocol for assessment of lumbar DDD, MEPC and HIZ resulting in ~60% time saving. ADVANCES IN KNOWLEDGE Grading of lumbar DDD, presence of Modic changes and high intensity zones were compared on sagittal T1W TSE, T2W FSE and STIR sequences with a T2W FSE Dixon sequence, with fair-to-good correlation suggesting that three conventional sequences could be replaced by a single Dixon sequence.
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Affiliation(s)
- Asif Saifuddin
- Department of Radiology, Royal National Orthopaedic Hospital, Stanmore, UK
| | | | - Rodney Santiago
- Department of Radiology, Royal National Orthopaedic Hospital, Stanmore, UK
| | - Mateen Siddiqui
- Department of Radiology, North West Anglia Foundation Trust, Hinchingbrooke Hospital, Huntingdon, UK
| | - Michael Khoo
- Department of Radiology, Royal National Orthopaedic Hospital, Stanmore, UK
| | - Ian Pressney
- Department of Radiology, Royal National Orthopaedic Hospital, Stanmore, UK
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Winfield JM, Blackledge MD, Tunariu N, Koh DM, Messiou C. Whole-body MRI: a practical guide for imaging patients with malignant bone disease. Clin Radiol 2021; 76:715-727. [PMID: 33934876 DOI: 10.1016/j.crad.2021.04.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 04/08/2021] [Indexed: 01/09/2023]
Abstract
Whole-body magnetic resonance imaging (MRI) is now a crucial tool for the assessment of the extent of systemic malignant bone disease and response to treatment, and forms part of national and international recommendations for imaging patients with myeloma or metastatic prostate cancer. Recent developments in scanners have enabled acquisition of good-quality whole-body MRI data within 45 minutes on modern MRI systems from all main manufacturers. This provides complimentary morphological and functional whole-body imaging; however, lack of prior experience and acquisition times required can act as a barrier to adoption in busy radiology departments. This article aims to tackle the former by reviewing the indications and providing guidance for technical delivery and clinical interpretation of whole-body MRI for patients with malignant bone disease.
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Affiliation(s)
- J M Winfield
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, 123 Old Brompton Road, London, SW7 3RP, UK; MRI Unit, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK
| | - M D Blackledge
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, 123 Old Brompton Road, London, SW7 3RP, UK; MRI Unit, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK
| | - N Tunariu
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, 123 Old Brompton Road, London, SW7 3RP, UK; MRI Unit, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK
| | - D-M Koh
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, 123 Old Brompton Road, London, SW7 3RP, UK; MRI Unit, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK
| | - C Messiou
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, 123 Old Brompton Road, London, SW7 3RP, UK; MRI Unit, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK.
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van Vucht N, Santiago R, Pressney I, Saifuddin A. Role of in-phase and out-of-phase chemical shift MRI in differentiation of non-neoplastic versus neoplastic benign and malignant marrow lesions. Br J Radiol 2021; 94:20200710. [PMID: 33571012 DOI: 10.1259/bjr.20200710] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To determine its ability of in-phase (IP) and out-of-phase (OOP) chemical shift imaging (CSI) to distinguish non-neoplastic marrow lesions, benign bone tumours and malignant bone tumours. METHODS CSI was introduced into our musculoskeletal tumour protocol in May 2018 to aid in characterisation of suspected bone tumours. The % signal intensity (SI) drop between IP and OOP sequences was calculated and compared to the final lesion diagnosis, which was classified as non-neoplastic (NN), benign neoplastic (BN) or malignant neoplastic (MN). RESULTS The study included 174 patients (84 males; 90 females: mean age 44.2 years, range 2-87 years). Based on either imaging features (n = 105) or histology (n = 69), 44 lesions (25.3%) were classified as NN, 66 (37.9%) as BN and 64 (36.8%) as MN. Mean % SI drop on OOP for NN lesions was 36.6%, for BN 3.19% and for MN 3.24% (p < 0.001). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of CSI for differentiating NN from neoplastic lesions were 65.9%, 94.6%, 80.6%, 89.1%% and 87.4% respectively, and for differentiating BN from MN were 9.1%, 98.4%, 85.7%, 51.2 and 53.1% respectively. CONCLUSION CSI is accurate for differentiating non-neoplastic and neoplastic marrow lesions, but is of no value in differentiating malignant bone tumours from non-fat containing benign bone tumours. ADVANCES IN KNOWLEDGE CSI is of value for differentiating non-neoplastic marrow lesions from neoplastic lesions, but not for differentiating benign bone tumours from malignant bone tumours as has been previously reported.
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Affiliation(s)
- Niels van Vucht
- Centre for Medical Imaging, University College London Hospitals, London, UK
| | - Rodney Santiago
- Department of Medical Imaging, Royal National Orthopaedic Hospital, Stanmore, UK
| | - Ian Pressney
- Department of Medical Imaging, Royal National Orthopaedic Hospital, Stanmore, UK
| | - Asif Saifuddin
- Department of Medical Imaging, Royal National Orthopaedic Hospital, Stanmore, UK
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T2-weighted Dixon MRI of the spine: A feasibility study of quantitative vertebral bone marrow analysis. Diagn Interv Imaging 2021; 102:431-438. [PMID: 33612414 DOI: 10.1016/j.diii.2021.01.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/17/2021] [Accepted: 01/30/2021] [Indexed: 12/30/2022]
Abstract
PURPOSE To compare the measurements of fat fraction (FF) and in-phase vs. opposed-phase ratio between two-dimensional T2-weighted (T2W) spin-echo (SE) Dixon and three-dimensional (3D) T1-weighted (T1W) volume interpolated breath-hold examination (VIBE) Dixon sequences in malignant vertebral lesions and normal vertebral bone marrow. MATERIALS AND METHODS Thirty patients with focal vertebral malignancies (20 men, mean age, 67.3±9.4 [SD] years; age range: 41-84 years) and 30 patients without malignant spinal disease (11 men, mean age, 70.1±12.9 [SD]; age range: 53-93 years) were retrospectively included. Each patient underwent spine MRI at 1.5 Tesla including T2W SE and T1W VIBE 2-point Dixon sequences. Two readers independently performed 3D-volume of interest (VOI) and region of interest (ROI)-based FF and IO-ratio measurements of malignant lesions and normal vertebrae. Student t-test, Pearson correlation (r) test and two-way mixed model intraclass correlation coefficients (ICC) were used to compare measurements. RESULTS T2W SE and T1W VIBE mean FF and IO-ratio were significantly smaller in malignancy compared to normal marrow, but there were significant differences of paired measurement mean values between T2W SE and T1W VIBE Dixon parameters in malignant lesions T2W SE VOI FF=9%, T2W SE ROI FF=7%, T2W SE IO-ratio=4% vs. T1W VIBE VOI FF=11%, T1W VIBE ROI FF=9%, T1W VIBE IO-ratio=-2%, and in normal vertebrae T2W SE VOI FF=74%, T2W SE ROI FF=77%, T2W SE IO-ratio=51% vs. T1W VIBE VOI FF=67%, T1W VIBE ROI FF=73%, T1W VIBE IO-ratio=58% (each P comparing the paired T2W TSE and T1W VIBE parameter, respectively<0.001). There was excellent positive correlation between T2W SE and T1W VIBE-FF (r≥0.99) and VOI and ROI FF measurements for each sequence (r≥0.99). Inter-reader agreement was excellent for all measurements (ICC≥0.94 for all). CONCLUSION Calculation of T2W SE Dixon derived FF is feasible and gave valid results that help discriminate between malignant vertebral lesions and normal vertebral bone marrow.
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