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Published on: January 29, 2018
Variation of the apparent diffusion coefficient of skull bone marrow by age group, pubertal status, and gender in a
Erika Pace1,2, Andrew D MacKinnon2,3, Nandita M deSouza1,2
1CRUK Imaging Centre, The Institute of Cancer Research, Sutton, UK.
Insights
Apparent diffusion coefficient (ADC) of clivus bone marrow decreases with age in children and significantly drops after puberty. This finding is consistent across genders and can serve as a benchmark for treatment effects.
Area of Science:
- Pediatric Radiology
- Biomedical Imaging
- Quantitative MRI
Background:
- Bone marrow composition undergoes significant changes throughout development.
- Understanding these changes is crucial for interpreting imaging findings in children.
Purpose of the Study:
- To determine age, pubertal status, and gender-specific differences in apparent diffusion coefficient (ADC) of clivus bone marrow in healthy children.
- To establish a normative benchmark for evaluating treatment-induced effects on bone marrow.
Main Methods:
- Diffusion-weighted magnetic resonance imaging (DW-MRI) was performed on 60 healthy pediatric patients (pre-pubertal and post-pubertal).
- Regions of interest were drawn in the clivus to calculate mean and centile ADC values.
- Statistical analyses, including Pearson's correlation and Mann-Whitney U tests, assessed relationships between ADC, age, pubertal status, and gender.
Main Results:
- A significant negative correlation was observed between age and ADC values in clivus bone marrow (P<0.001).
- ADC values decreased significantly after puberty in both boys and girls (P<0.05).
- No significant gender-related differences in ADC were found before or after puberty.
Conclusions:
- Clivus bone marrow ADC is a reliable indicator of age and pubertal status in children.
- The observed decrease in ADC post-puberty is likely due to the replacement of hematopoietic marrow with fatty marrow.
- These findings provide essential normative data for pediatric bone marrow imaging.
Background:
Bone marrow composition varies with stage of development.
Purpose:
To assess differences in apparent diffusion coefficient (ADC) derived from clivus bone marrow in healthy children by age, pubertal status, and gender as a benchmark when monitoring local and systemic treatment-induced effects.
Material And Methods:
Non-oncological pediatric patients (30 pre-pubertal [15 girls, 15 boys] and 30 post-pubertal [15 girls, 15 boys]) with previous normal magnetic resonance imaging (MRI) of the brain including diffusion-weighted magnetic resonance imaging (DW-MRI; 1.5-T Philips Achieva-Ingenia, b-values 0 and 1000s/mm2) were studied. A 4-6 mm diameter region of interest (ROI), drawn within the clivus on two or three DW-MRI slices, yielded mean and centile ADC values. Pubertal status was recognized from imaging appearances of the pituitary gland and from fusion of the spheno-occipital synchondrosis. Correlations between ADC and age were assessed (Pearson's coefficient). Mann-Whitney U tests compared ADC by age, pubertal status, and gender.
Results:
Age and ADC were significantly negatively correlated (median ADC r=-0.48, mean ADC r=-0.42, P=0.0001 and 0.0008, respectively) which held true when divided by gender. Mean and median ADC differed significantly before and after puberty for the whole population (P=0.0001 and 0.0001, respectively). There was a left shift of the ADC histogram after puberty with significant differences in centile values. ADC differences before and after puberty remained when divided by gender (girls: P=0.04 and 0.009, respectively; boys: P=0.005 and 0.0002, respectively).
Conclusion:
ADC of clivus bone marrow correlates with age in children. ADC decreases significantly after puberty, likely due to replacement of hypercellular marrow with fat. There are no gender-related differences in clivus bone-marrow ADC before or after puberty.
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