Diffusion-weighted imaging of bone marrow: current status

Baur, Andrea; Dietrich, Olaf; Reiser, Maximilian

doi:10.1007/s00330-003-1873-0

Cited by 106 publications

(60 citation statements)

References 40 publications

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“…Insight into ctH 2 O can be derived from MRI studies of the apparent diffusion coefficient of water (ADC w ). The ADC w correlates with cellular density in several tissues, including brain (42)(43)(44), breast (45)(46)(47), and bone marrow (48). Detailed studies using human melanoma xenografts (49) and breast tumor animal models (50) have supported these findings.…”

Section: Discussionmentioning

confidence: 93%

“…Detailed studies using human melanoma xenografts (49) and breast tumor animal models (50) have supported these findings. The ADC w also relates to cellular pathology (48,51). Optically detected changes in ctH 2 O may represent subtle variations in tumor cell density and edema, where reductions in tumor water imply diminished cellularity due to cell death (52).…”

Section: Discussionmentioning

confidence: 99%

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Predicting response to breast cancer neoadjuvant chemotherapy using diffuse optical spectroscopy

Cerussi

Hsiang

Shah

et al. 2007

Proc. Natl. Acad. Sci. U.S.A.

272

259

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Diffuse optical spectroscopy (DOS) and imaging are emerging diagnostic techniques that quantitatively measure the concentration of deoxy-hemoglobin (ctHHb), oxy-hemoglobin (ctO 2Hb), water (ctH 2O), and lipid in cm-thick tissues. In early-stage clinical studies, diffuse optical imaging and DOS have been used to characterize breast tumor biochemical composition and monitor therapeutic response in stage II/III neoadjuvant chemotherapy patients. We investigated whether DOS measurements obtained before and 1 week into a 3-month adriamycin/cytoxan neoadjuvant chemotherapy regimen can predict final, postsurgical pathological response. Baseline DOS measurements of 11 patients before therapy revealed significant increases in tumor ctHHb, ctO 2Hb, ctH 2O, and spectral scattering slope, and decreases in bulk lipids, relative to normal breast tissue. Tumor concentrations of ctHHb, ctO 2Hb, and ctH2O dropped 27 ؎ 15%, 33 ؎ 7%, and 11 ؎ 15%, respectively, within 1 week (6.5 ؎ 1.4 days) of the first treatment for pathology-confirmed responders (n ‫؍‬ 6), whereas nonresponders (n ‫؍‬ 5) and normal side controls showed no significant changes in these parameters. The best single predictor of therapeutic response 1 week posttreatment was ctHHb (83% sensitivity, 100% specificity), while discrimination analysis based on combined ctHHb and ctH 2O changes classified responders vs. nonresponders with 100% sensitivity and specificity. In addition, the pretreatment tumor-to-normal ctO 2Hb ratio was significantly higher in responders (2.82 ؎ 0.44) vs. nonresponders (1.82 ؎ 0.49). These results highlight DOS sensitivity to tumor cellular metabolism and biochemical composition and demonstrate its potential for predicting and monitoring an individual's response to treatment.diffuse optical imaging ͉ frequency-domain photon migration ͉ near-infrared ͉ tissue spectroscopy ͉ translational research O ptimal management locally advanced breast cancer (LABC) remains a complex therapeutic problem (1). LABC represents 5-20% of all newly diagnosed breast cancers in the United States with a higher incidence in medically underserved areas (2). Treatment for LABC has evolved from radical mastectomy to preoperative neoadjuvant chemotherapy followed by mastectomy or breast conservation therapy (3). Despite aggressive local therapy, long-term patient survival is still poor. LABC remains controversial because of uncertainties in determining the optimal intensity and duration of neoadjuvant chemotherapy and evaluating therapeutic response (2, 4, 5).Neoadjuvant chemotherapy response is determined by serial physical examination, mammography and/or ultrasound. Complete pathological response (cPR) is an important therapeutic endpoint that is a surrogate for eradicating micrometastases, and strongly correlates with patient survival (6). Thus one goal of neoadjuvant chemotherapy monitoring is to determine early when a patient will demonstrate cPR. Many studies revealed significant discrepancies between clinical response assessments and final pathology (7-9).A rece...

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Predicting response to breast cancer neoadjuvant chemotherapy using diffuse optical spectroscopy

Cerussi

Hsiang

Shah

et al. 2007

Proc. Natl. Acad. Sci. U.S.A.

272

259

View full text Add to dashboard Cite

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“…Immature skeletal structures in children, including the proximal femur, contain more water than in adults, making them well suited for evaluation. Diffusion is normally greater in areas of higher cellularity and appears to be greater in hematopoietic than in fatty marrow [1]. As would be expected from the greater diffusion in hematopoietic marrow, it is not surprising that ADC ratio (%) marrow diffusion decreases with age.…”

Section: Discussionmentioning

confidence: 94%

Diffusion-weighted MRI Reveals Epiphyseal and Metaphyseal Abnormalities in Legg-Calvé-Perthes Disease: A Pilot Study

Yoo

Kim

Menezes

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background Legg-Calvé-Perthes disease (LCP) is thought to be associated with ischemic events in the femoral head. However, the types and patterns of reperfusion after these ischemic events are unclear. Purposes We therefore determined whether (1) there would be any age-related diffusion changes; (2) diffusionweighted MR imaging would reveal ischemic damage; and (3) diffusion changes are correlated with prognostic MR findings in patients with LCP. Methods We prospectively performed conventional, perfusion, and diffusion-weighted MR imaging studies in 17 children with unilateral LCP. We then measured the apparent diffusion coefficient (ADC) values in the epiphysis and the metaphysis, and compared them with those of the contralateral normal side. Based on perfusion MR imaging, we assessed reperfusion to the epiphysis as either periphyseal or transphyseal. We studied T2-signal intensity changes in the metaphysis and the presence of focal physeal irregularity. We correlated diffusion changes with reperfusion to the epiphysis, T2-signal intensity change, and focal physeal irregularity. Results Normal diffusion decreased with age. In LCP hips, epiphyseal diffusion increased early and remained elevated through the healing stage. Six of the 17 patients who had a metaphyseal ADC greater than 50% over the Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained. 123Clin Orthop Relat Res (2011) 469:2881-2888 DOI 10.1007/s11999-011-1931 normal side had 13 times greater odds of having an association with transphyseal reperfusion to the epiphysis. The increase of metaphyseal ADC also was associated with an increased T2-signal intensity in the metaphysis and presence of focal physeal irregularity. Conclusions Diffusion-weighted MR imaging can be used as a complimentary modality to evaluate ischemic tissue damage with a potential prognostic value in patients with LCP.

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“…In comparison to radiographic evaluation, MRI has shown accuracy in the differential diagnosis of osteoporotic versus metastatic fracture by using either diffusion-weighted imaging 10 (bone marrow is hypointense [dark] in the acute benign collapse and hyperintense [bright] in fractures secondary to metastatic tumors) or criteria related to the morphometrical features of the fracture, known as the "fluid sign." 13 The fluid sign, suggestive of bone marrow edema, has been a common feature of acute osteoporotic vertebral compression fractures in which bone marrow has been displaced.…”

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confidence: 99%