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Assessing the relation between bone marrow signal intensity and apparent diffusion coefficient in diffusion-weighted

Anwar R Padhani1, Katherine van Ree, David J Collins

  • 1Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Rickmansworth Rd, Northwood, Middlesex, HA6 2RN, UK. anwar.padhani@stricklandscanner.org.uk

AJR. American Journal of Roentgenology
|December 21, 2012
PubMed
Summary

This study shows that signal intensity (SI) and apparent diffusion coefficient (ADC) measurements can differentiate normal bone marrow from myeloma and breast cancer metastases. These findings establish upper ADC limits for untreated bone marrow tumors.

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Area of Science:

  • Radiology
  • Oncology
  • Medical Imaging

Background:

  • Bone marrow signal intensity (SI) and apparent diffusion coefficient (ADC) are key MRI parameters.
  • Differentiating malignant bone marrow lesions from normal tissue is crucial for diagnosis and treatment planning.

Purpose of the Study:

  • To investigate the relationship between high b-value SI and ADC in bone marrow.
  • To establish cutoff values for distinguishing malignant from normal bone marrow.
  • To determine upper ADC limits for untreated multiple myeloma and breast cancer bone metastases.

Main Methods:

  • Retrospective analysis of body diffusion-weighted MRI in patients with myeloma, breast cancer metastases, and healthy controls.
  • Comparison of SI and ADC values between normal bone marrow and tumor lesions.
  • Statistical analyses including nonparametric, ROC, and nonlinear regression.

Main Results:

  • Lower ADC values were observed in normal yellow and red bone marrow compared to tumor lesions (p < 0.001).
  • Tissue-normalized SI and signal-to-noise ratio were also lower in normal bone marrow (p < 0.001).
  • A nonlinear relationship was found between SI and ADC, with upper limits for tumor ADC values identified.

Conclusions:

  • Both normalized SI and ADC effectively differentiate normal bone marrow from myeloma and breast cancer metastases.
  • The nonlinear SI-ADC relationship aids in defining upper ADC limits for untreated bone marrow malignancies.