In-phase and out-of-phase MR imaging of bone marrow: prediction of neoplasia based on the detection of coexistent fat and water.

Disler, David G.; McCauley, Thomas R.; Ratner, L M; Kesack, C D; Cooper, James A.

doi:10.2214/ajr.169.5.9353477

Cited by 173 publications

(137 citation statements)

References 32 publications

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“…Further advantages include insensitivity to field inhomogeneities (7) due to paramagnetic substances in bone marrow (18). The opposed-phase technique is based on phase differences of fat and water protons (7,10). Because of the similar fat and water fractions of hematopoietic bone marrow (3), the signal derived from both fractions is canceled by use of an appropriate TE at which the phase shifts are 180°from each other (7).…”

Section: Discussionmentioning

confidence: 99%

“…Seiderer et al (9) showed that the signal in opposed-phase images correlates to the fat/water fraction. Since normal red marrow exhibits low signal in opposed-phase images, pathological processes that result in an increase of water are indicated by high signal (9,10). This sequence proved to be useful in the evaluation of hematopoietic hyperplasia as a result of therapy with granulocyte-colony stimulating factor (G-CSF) in healthy blood stem cell donors at low-field strength (4).…”

Section: Discussionmentioning

confidence: 99%

“…The underlying process of a relative increase of the water fraction in relation to the fatty component is similar for hematological diseases and stimulated hematopoiesis (1,4). Opposedphase gradient-echo (GE) sequences are sensitive to changes of the fat-to-water ratio (9) and are therefore especially suitable for imaging bone marrow (10). Increased hematopoietic demand may lead to imaging findings consistent with hematopoietic hyperplasia due to anemia, low oxygen tension, or cigarette smoking (3,11,12).…”

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Characterization of hematopoietic bone marrow in male professional cyclists by magnetic resonance imaging of the lumbar spine

Altehoefer

Schmid

Büchert

et al. 2002

Magnetic Resonance Imaging

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Purpose: To prospectively evaluate hematopoietic bone marrow of male professional cyclists in relation to performance data and laboratory data, and in comparison to age-matched healthy volunteers. Materials and Methods:Twenty male cyclists and 44 volunteers (27 males and 17 females) were prospectively studied by magnetic resonance imaging (MRI) at high-field strength. A sagittal T1-weighted (T1-w) spin-echo (SE) sequence, a gradient-echo (GE) sequence with an echo time (TE) for out-of-phase (OOP) imaging, and a turbo inversionrecovery sequence with short inversion time (TIRM) for fat suppression was used. The averaged bone marrow signal intensity (SI) of three adjacent vertebrae was related to the signal of an adjacent nondegenerative disk. Results:The cyclists revealed a significantly different SI as compared to male volunteers in the OOP (0.34 Ϯ 0.14 vs. 0.28 Ϯ 0.09, P Ͻ 0.05) and T1-w sequences (1.62 Ϯ 0.19 vs. 1.77 Ϯ 0.30, P Ͻ 0.05). Only in TIRM was there a significant difference compared to female volunteers (0.36 Ϯ 0.08 vs. 0.44 Ϯ 0.04, P Ͻ 0.01). MRI data of cyclists did not correlate to hemoglobin, erythrocyte, or reticulocyte counts; ferritin, relative heart volume, relative maximal power (rPmax; W/kg bw), or relative maximal oxygen consumption (VO 2 max). A borderline linear correlation was found for hematocrit (OOP: r ϭ 0.42, P ϭ 0.06; TIRM: r ϭ 0.44, P ϭ 0.06). Conclusion:Bone marrow hyperplasia is observed in male professional cyclists in the axial skeleton. The MR findings are probably independent of mechanically induced marrow edema. A multifactorial cause must be considered, as single laboratory and performance data did not appear to contribute significantly to these results.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Characterization of hematopoietic bone marrow in male professional cyclists by magnetic resonance imaging of the lumbar spine

Altehoefer

Schmid

Büchert

et al. 2002

Magnetic Resonance Imaging

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“…Disler et al [15] studied the relative signal intensity ratios (defined as the ratio of signal intensity of a lesion versus control tissue on opposed-phase imaging divided by the corresponding ratio on in-phase imaging) of lesions in appendicular and pelvic bones. They found that the average relative signal intensity ratio for neoplastic lesions was 1.03, versus 0.61 for non-neoplastic lesions; using a relative signal intensity ratio higher than 0.81 resulted in a sensitivity and specificity of 95% for detection of a tumor.…”

Section: Fat and Water Contentmentioning

confidence: 99%

Magnetic resonance imaging of bone marrow in oncology, Part 1

Hwang

Panicek

2007

Skeletal Radiol

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Magnetic resonance imaging plays an integral role in the detection and characterization of marrow lesions, planning for biopsy or surgery, and post-treatment followup. To evaluate findings in bone marrow on MR imaging, it is essential to understand the normal composition and distribution of bone marrow and the changes in marrow that occur with age, as well as the basis for the MR signals from marrow and the factors that affect those signals. The normal distribution of red and yellow marrow in the skeleton changes with age in a predictable sequence. Important factors that affect MR signals and allow detection of marrow lesions include alterations in fat-water distribution, destruction of bony trabeculae, and contrast enhancement. This two-part article reviews and illustrates these issues, with an emphasis on the practical application of MR imaging to facilitate differentiation of normal marrow, tumor, and treatment-related marrow changes in oncology patients.

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“…However, water protons process fractionally faster than lipid protons, resulting in a phase difference gradually reaching 1800 in a few milliseconds, which means the phase is opposed, and a refocusing pulse in the GRE sequence can demonstrate the difference between fat and water signal by subtracting them (9 -11). This fat suppression, to some extent, was used to differentiate or reveal the lesions having small amounts of fat and is said to be helpful especially in characterizing the malignant nature of the spinal lesions (9,(11)(12)(13)(14). Now, this technique may gain a newer perspective, establishing an intrinsic value due to its capability to image the spinal structures other than bone marrow, especially the intervertebral disc material, by taking advantage of faster acquisition times in lumbar disc disease.…”

Section: Discussionmentioning

confidence: 99%

Opposed phase imaging in lumbar disc disease: An option providing faster image acquisition times

Yağmurlu

Erden

Tanju

et al. 2007

Magnetic Resonance Imaging

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Purpose:To investigate the utility of opposed phase imaging (OPI) (in-phase and out-of-phase) in lumbar disc disease. Materials and Methods:A total of 127 patients suspected of disc disease were examined with both traditional lumbar spine protocol (fast spin-echo [FSE] T1-weighted, T2-weighted sagittal, and T2-weighted axial) and OPI. Images were evaluated to detect the disc disease and to assess the anatomical clarity of certain spinal structures by two different radiologists using a four-point scale (1 ϭ inadequate, 2 ϭ adequate, 3 ϭ good, and 4 ϭ optimal). Results of two methods in terms of pathologic conditions and anatomical structures were compared. Comparison of the methods and the interpretations of two radiologists were performed by using kappa statistics. The difference among two methods in terms of anatomic clarity was assessed by using Wilcoxon analysis.Results: Disc disease detected by each technique demonstrated concurrence (agreement was 82.4% and 93.1% for two radiologists; P Ͻ 0.05). OPI received similar scores with conventional sequences for disc disease (P Ͼ 0.05). OPI was optimal in displaying disc, marrow, osteophytes, and hemangiomas, where other structures got higher scores on conventional images (P Ͼ 0.05 and P Ͼ 0.001). But these structures had equal scores at least in one of the opposedphase images. Acquisition time for OPI and conventional images were 4.46 and 9.01 minutes, respectively. Conclusion:OPI can be a faster backup technique in evaluating the lumbar disc disease. It has a shorter image acquisition time with adequate diagnostic quality. It can be a "time saver" option for busy MR centers or may be used for patients who cannot tolerate longer acquisition times.

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In-phase and out-of-phase MR imaging of bone marrow: prediction of neoplasia based on the detection of coexistent fat and water.

Abstract: OBJECTIVE.The purpose of this study was to determine if gradient-echo MR imagingwith TEs selected with fat and water in phase and out of phase can help predict the likelihood of neoplastic or nonneoplastic lesions in bone marrow. SUBJECTS

Cited by 173 publications

References 32 publications

Characterization of hematopoietic bone marrow in male professional cyclists by magnetic resonance imaging of the lumbar spine

Characterization of hematopoietic bone marrow in male professional cyclists by magnetic resonance imaging of the lumbar spine

Magnetic resonance imaging of bone marrow in oncology, Part 1

Opposed phase imaging in lumbar disc disease: An option providing faster image acquisition times

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