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Differentiation of focal indeterminate marrow abnormalities with multiparametric MRI
Jun Seung Baik1, Joon-Yong Jung1, Won-Hee Jee1
1Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea.
Purpose:
To explore magnetic resonance imaging (MRI) parameters from intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI), multiecho Dixon imaging (ME-Dixon), and dynamic contrast-enhanced imaging (DCE) for differentiating focal indeterminate marrow abnormalities MATERIALS AND METHODS: Forty-two patients with 14 benign and 28 malignant focal marrow abnormalities were included. The following were independently analyzed by two readers: signal intensity (SI), contour, and margin on conventional MR images; SI on b-800 images (SIb-800 ), apparent diffusion coefficient (ADC), IVIM parameters (Dslow, Dfast , and f), fat fraction (Ff), and DCE parameters (time-to-signal intensity curve pattern, iAUC, Ktrans , kep , and ve ). The MR characteristics and parameters from benign and malignant lesions were compared with a chi-squared test and the Mann-Whitney U-test, respectively. The area under receiver operating characteristic (ROC) curves (AUC) of each sequence were also compared. Interobserver agreements were assessed with Cohen's κ, and intraclass correlation coefficient (ICC).
Results:
ADC, Dslow , and Ff demonstrated a significant difference between benign and malignant marrow abnormalities for both readers (P < 0.001). SIb-800 and perfusion-related parameters from IVIM-DWI and DCE were not significantly different between the two groups (P = 0.145, 0.439, and 0.337 for reader 1, P = 0.378, 0.368, and 0.343 for reader 2, respectively). The AUCs of ADC, Dslow , and Ff were significantly higher for differentiating indeterminate marrow abnormalities in both readers (P < 0.001). Interobserver agreements were substantial in SIb-800 , and ICCs were almost perfect for ADC, Dslow , f, and Ff, and substantial for iAUC, kep , Ktrans , ve , and Dfast .
Conclusion:
ADC, Dslow , and Ff may provide information for differentiating focal indeterminate abnormalities.
Level Of Evidence:
3 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;46:49-60.
Insights
Apparent diffusion coefficient (ADC), slow diffusion (Dslow), and fat fraction (Ff) effectively differentiate benign from malignant marrow abnormalities. These MRI parameters show high accuracy and reliability for diagnosing indeterminate focal marrow lesions.
Area of Science:
- Radiology
- Medical Imaging
- Oncology
Background:
- Focal marrow abnormalities present diagnostic challenges.
- Differentiating benign from malignant lesions is crucial for patient management.
Purpose of the Study:
- To evaluate magnetic resonance imaging (MRI) parameters from intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI), multiecho Dixon imaging (ME-Dixon), and dynamic contrast-enhanced imaging (DCE) for differentiating focal indeterminate marrow abnormalities.
- To assess the diagnostic performance and interobserver agreement of these advanced MRI techniques.
Main Methods:
- Retrospective analysis of 42 patients with focal marrow abnormalities (14 benign, 28 malignant).
- Independent assessment of conventional MRI, IVIM-DWI, ME-Dixon, and DCE parameters by two readers.
- Statistical comparison of parameters between benign and malignant lesions using chi-squared and Mann-Whitney U-tests.
- Receiver operating characteristic (ROC) curve analysis to determine diagnostic accuracy.
Main Results:
- Apparent diffusion coefficient (ADC), slow diffusion (Dslow), and fat fraction (Ff) showed significant differences between benign and malignant marrow abnormalities (P < 0.001).
- Signal intensity on b-800 images (SIb-800) and perfusion parameters from IVIM-DWI and DCE did not significantly differentiate the groups.
- ADC, Dslow, and Ff demonstrated high areas under the ROC curve (AUCs) for differentiating indeterminate marrow abnormalities.
- Excellent interobserver agreement was observed for ADC, Dslow, f, and Ff.
Conclusions:
- ADC, Dslow, and Ff are valuable quantitative MRI parameters for differentiating focal indeterminate marrow abnormalities.
- These parameters offer high diagnostic accuracy and reliability, aiding in the distinction between benign and malignant lesions.
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