TY - JOUR
TI - Quantitative diffusion-weighted imaging of the bone marrow: An adjunct tool for the diagnosis of a diffuse MR imaging pattern in patients with multiple myeloma
AU - Koutoulidis, V.
AU - Fontara, S.
AU - Terpos, E.
AU - Zagouri, F.
AU - Matsaridis, D.
AU - Christoulas, D.
AU - Panourgias, E.
AU - Kastritis, E.
AU - Dimopoulos, M.A.
AU - Moulopoulos, L.A.
JO - Dentomaxillofacial Radiology
PY - 2017
VL - 282
TODO - 2
SP - 484-493
PB - Radiological Society of North America Inc.
SN - null
TODO - 10.1148/radiol.2016160363
TODO - adult;  aged;  apparent diffusion coefficient;  Article;  bone marrow;  cancer staging;  controlled study;  diagnostic accuracy;  diffusion weighted imaging;  female;  human;  major clinical study;  male;  multiple myeloma;  nuclear magnetic resonance imaging;  nuclear magnetic resonance scanner;  prospective study;  receiver operating characteristic;  sensitivity and specificity;  bone marrow;  case control study;  diagnostic imaging;  diffusion weighted imaging;  middle aged;  multiple myeloma;  pathology;  procedures;  very elderly, Adult;  Aged;  Aged, 80 and over;  Bone Marrow;  Case-Control Studies;  Diffusion Magnetic Resonance Imaging;  Female;  Humans;  Male;  Middle Aged;  Multiple Myeloma;  Prospective Studies
TODO - Purpose: To evaluate the apparent diffusion coeffcients (ADCs) of magnetic resonance (MR) imaging patterns in the bone marrow of patients with multiple myeloma (MM) and to determine a threshold ADC that may help distinguish a diffuse from a normal pattern with high accuracy. Materials and Methods: This prospective study was approved by the ethics review board, and informed consent was obtained. Ninety-nine patients with newly diagnosed, untreated MM and 16 healthy control subjects underwent spinal MR imaging including diffusion-weighted imaging, and bone marrow ADCs were calculated. Pattern assignment was based on visual assessment of conventional MR images. The Kruskal-Wallis H test, the Mann-Whitney test, and the oneway analysis of variance were used to compare ADCs between patient subsets and control subjects, and a receiver operating characteristic analysis was performed. Results: Mean ADCs ± standard deviation in patients with MM for the normal, focal, and diffuse MR imaging patterns were 0.360 × 1023 mm2/sec ± 0.110, 1.046 × 1023 mm2/sec ± 0.232, and 0.770 × 1023 mm2/sec ± 0.135, respectively. There were signifcant differences in ADCs between diffuse and normal (P <.001), diffuse and focal (P <.001), and focal and normal (P <.001) patterns. Patients with a diffuse pattern had more features of advanced disease, higher international staging system score, increased incidence of high-risk cytogenetics, and higher revised international staging system score. ADCs greater than 0.548 × 1023 mm2/sec showed 100% sensitivity (26 of 26) and 98% specifcity (48 of 49) for the diagnosis of a diffuse (vs normal) MR imaging pattern, whereas an ADC greater than 0.597 × 1023 mm2/sec showed 96% sensitivity (25 of 26) and 100% specifcity (49 of 49). Conclusion: ADCs of MR imaging patterns in patients with MM differ signifcantly. A diffuse MR imaging pattern can be distinguished more objectively from a normal MR imaging pattern by adding quantitative diffusion-weighted imaging to standard MR imaging protocols. © 2016 RSNA.
ER -