Intravoxel incoherent motion diffusion‐weighted imaging of bone marrow in patients with acute myeloid leukemia: a pilot study of prognostic value

Background Postcontrast‐enhanced MRI is currently the reference standard for synovial proliferation in rheumatoid arthritis (RA). However, the technique is somewhat invasive due to the use of gadolinium contrast agents, which may cause severe adverse/side effects. Intravoxel incoherent motion (IVIM) simultaneously permits quantification of perfusion as well as diffusion using a single imaging scan. Purpose/Hypothesis To test the capability of IVIM MRI for noninvasive discrimination of synovial proliferation in hand arthritis. Study Type Prospective. Subjects Seven suspected RA patients (three women and four men; mean age, 61 years; range, 26–74 years). Field Strength/Sequence 3 T/short tau inversion recovery (STIR), IVIM, postcontrast‐enhanced MRI. Assessment Region of interest (ROI) was identified based on STIR. Contrast‐enhanced MRI was evaluated using a 5‐point grading scale of 0 (water) to 4 (synovial proliferation) according to the degree of contrast enhancement within the ROI. For each ROI, we calculated the apparent diffusion coefficient (ADC) and IVIM parameters (molecular diffusion coefficient [D], perfusion fraction [f], and perfusion‐related diffusion coefficient [D*]). These parameters were subsequently compared with ROI contrast enhancement grades. Statistical Tests Spearman's rank correlation test and a receiver operating characteristic (ROC) curve. Results A total of 90 ROIs of suspected synovial proliferation and/or joint effusion were identified. ROI grades were correlated with ADC and D values (r S = –0.385, P < 0.001, r S = –0.458, P < 0.0001, respectively), but not with the f and D* values (r S = –0.010, P = 0.936, r S = –0.084, P = 0.505, respectively). The area under the curves (AUCs) of D values (0.708–0.888, P = 0.002–0.0002) were slightly larger than those of ADC values (0.692–0.791, P = 0.013–0.001) when comparing low‐ vs. high‐contrast enhancement grades. Data Conclusion The IVIM parameter D and ADC may be useful for the noninvasive identification of synovial proliferation in hand arthritis. Level of Evidence: 2 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2019;50:1199–1206.

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Intravoxel incoherent motion MRI for discrimination of synovial proliferation in the hand arthritis: A prospective proof‐of‐concept study

Fujimori

Murakami

Sugimori

et al. 2019

“…One study analyzed IVIM parameters prior to chemotherapy and looked at the differences between complete remission and nonremission groups. 71 Interestingly, in the complete remission group they found that D was significantly higher (0.24 AE 0.04 vs. 0.20 AE 0.03 × 10 −3 mm 2 /s) and f was significantly lower (22.38 AE 5.19 vs. 27.89 AE 8.25 × 10 −3 mm 2 /s) than in the nonremission group. Because ADC had not shown significant differences, they suggested D and f values could be used as biomarkers to prognosticate AML.…”

Section: Ivim For Osseous Tumor Gradingmentioning

confidence: 89%

“…In acute myeloid leukemia (AML), high cellularity and angiogenesis of marrow are regarded as a poor prognosis. One study analyzed IVIM parameters prior to chemotherapy and looked at the differences between complete remission and nonremission groups . Interestingly, in the complete remission group they found that D was significantly higher (0.24 ± 0.04 vs. 0.20 ± 0.03 × 10 −3 mm 2 /s) and f was significantly lower (22.38 ± 5.19 vs. 27.89 ± 8.25 × 10 −3 mm 2 /s) than in the nonremission group.…”

Section: Intravoxel Incoherent Motion (Ivim)mentioning

confidence: 99%

MRI biomarkers in osseous tumors

Fukuda

Wengler

Carvalho

et al. 2019

Although radiography continues to play a critical role in osseous tumor assessment, there have been remarkable advances in cross‐sectional imaging. MRI has taken a lead in this assessment due to high tissue contrast and spatial resolution, which are well suited for bone lesion assessment. More recently, although somewhat lagging other organ systems, quantitative parameters have shown promising potential as biomarkers for osseous tumors. Among these sequences are chemical shift imaging (CSI), apparent diffusion coefficient (ADC), and intravoxel incoherent motion (IVIM) from diffusion‐weighted imaging (DWI), quantitative dynamic contrast enhanced (DCE)‐MRI, and magnetic resonance spectroscopy (MRS). In this article, we review the background and recent roles of these quantitative MRI biomarkers for osseous tumors. Level of Evidence: 3 Technical Efficacy Stage: 3 J. MAGN. RESON. IMAGING 2019. J. Magn. Reson. Imaging 2019;50:702–718.

“…As a result, the IVIM technique can now be applied to various tissues. Surprisingly, however, only a very limited number of IVIM studies have been performed on bone marrow . This might be due to lipids, which represent a major confounding factor in the quantification of both diffusion and perfusion .…”

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confidence: 99%

Measurements of Diffusion and Perfusion in Vertebral Bone Marrow Using Intravoxel Incoherent Motion (IVIM) With Multishot, Readout‐Segmented (RESOLVE) Echo‐Planar Imaging

Lasbleiz

Ster

Guillin

et al. 2018