Τίτλος:
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
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
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.
Συγγραφείς:
Koutoulidis, V.
Fontara, S.
Terpos, E.
Zagouri, F.
Matsaridis, D.
Christoulas, D.
Panourgias, E.
Kastritis, E.
Dimopoulos, M.A.
Moulopoulos, L.A.
Περιοδικό:
Dentomaxillofacial Radiology
Εκδότης:
Radiological Society of North America Inc.
Λέξεις-κλειδιά:
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
DOI:
10.1148/radiol.2016160363
