Pediatric skeletal diffusion-weighted magnetic resonance imaging, part 2: current and emerging applications

Chaturvedi, Apeksha

doi:10.1007/s00247-021-05028-5

Cited by 13 publications

(9 citation statements)

References 78 publications

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“…Diffusion-weighted imaging (DWI) is routine in central nervous system (CNS) diagnostics [ 1 ], whole-body imaging (WBI) [ 2 ], in oncological questions [ 3 ] and suspected inflammatory processes [ 4 ]. In abdominal magnetic resonance imaging (MRI), diffusion-weighted sequences can reliably detect lesions and provide functional information on tumor tissue, like cellular density [ 5 – 7 ].…”

Section: Introductionmentioning

confidence: 99%

Preliminary results of abdominal simultaneous multi-slice accelerated diffusion-weighted imaging with motion-correction in patients with cystic fibrosis and impaired compliance

et al. 2022

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Objectives The aim of this prospective study was to compare scan time, image quality, signal-to-noise Ratio (SNR), and apparent diffusion coefficient (ADC) values of simultaneous multi-slice accelerated diffusion-weighted imaging with motion-correction (DWI SMS Moco) to standard diffusion-weighted imaging (sDWI) in free-breathing abdominal magnetic resonance imaging (MRI) in pediatric and young adult patients with cystic fibrosis (CF). Material and methods 16 patients (7 male and 9 female, 12–41 years old) with CF were examined prospectively in a single-center from November 2020 to March 2021 on a 1.5 Tesla clinical MR scanner. The characteristics of overall image quality and delimitability of mesenteric lymph nodes were evaluated using a 5-point Likert scale by two experienced pediatric radiologists independently from each other. Quantitative parameters with SNR and ADC values were assessed in 8 different locations and compared using a Wilcoxon signed-rank test. Results The acquisition time for DWI SMS Moco was 32% shorter than for sDWI. Regarding quality comparison, overall image quality and delimitability of mesenteric lymph nodes were significant higher in DWI SMS Moco (p ≤ 0.05 for both readers). The readers preferred DWI SMS Moco to sDWI in all cases (16/16). Mean SNR values from DWI SMS Moco and sDWI were similar in 7 from 8 locations. The ADC values showed no significant difference between DWI SMS Moco and sDWI in any of the evaluated locations (p > 0.05). Conclusions The DWI SMS Moco improves overall image quality and delimitability of mesenteric lymph nodes compared to sDWI with similar SNR and ADC values and a distinguished reduction of scan time in free-breathing by one third. We conclude that MRI with DWI SMS Moco could be helpful in monitoring the effect of the high-efficiency modulator (HEM) therapy in cystic fibrosis (CF) patients homozygous or heterozygous for F508del in the abdomen.

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Section: Introductionmentioning

confidence: 99%

Preliminary results of abdominal simultaneous multi-slice accelerated diffusion-weighted imaging with motion-correction in patients with cystic fibrosis and impaired compliance

et al. 2022

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“…To avoid gadolinium injection, we evaluated the diagnostic performance of an unenhanced protocol with DWI in comparison with a standard contrast-enhanced MRI. To our knowledge, DWI is not currently part of routine pediatric MRI protocols for osteoarticular infection in most centers, although recently, Chaturvedi [ 29 ] reported the usefulness of DWI to assess for subperiosteal abscess in children based on unpublished data. So far, only adult studies have emphasized that ADC values can differentiate osteomyelitis from noninfectious bone marrow edema [ 17 , 30 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

Benefits of diffusion-weighted imaging in pediatric acute osteoarticular infections

et al. 2022

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Background Contrast-enhanced magnetic resonance imaging (MRI) is recommended for the diagnosis of acute osteoarticular infections in children. Diffusion-weighted imaging (DWI) may be an alternative to the injection of gadolinium. Objective To evaluate unenhanced MRI with DWI in comparison to contrast-enhanced MRI for the diagnostic work-up of acute osteoarticular infections in children. Materials and methods This retrospective study included 36 children (age range: 7 months-12 years) with extra-spinal osteoarticular infections and MRI performed within 24 h of admission. MRI protocol included short tau inversion recovery (STIR), water-only T2 Dixon, T1, DWI, and gadolinium-enhanced T1 sequences. Two readers reviewed three sets of images: 1) unenhanced sequences, 2) unenhanced sequences with DWI and 3) unenhanced followed by contrast-enhanced sequences (reference standard). Sensitivity and specificity of sets 1 and 2 were compared to set 3 and assessed to identify osteoarticular infections: osteomyelitis (long bones, metaphyseal equivalents), septic arthritis and abscess (soft tissues, bone). Results All 14 cases of osteomyelitis in the metaphyses and diaphyses of long bones and all 27 cases of septic arthritis were identified by unenhanced sequences, but 4/16 abscesses were missed. For the diagnosis of abscess, DWI increased sensitivity to 100%. Among the 18 osteomyelitis in metaphyseal equivalents, 4 femoral head chondroepiphyses were identified by contrast-enhanced sequences only. Conclusion MRI for suspected pediatric acute osteoarticular infections is the best diagnostic modality to guide patient management. An unenhanced protocol with DWI may be an alternative to a contrast-based protocol, even in the presence of an abscess. However, gadolinium remains necessary to assess for chondroepiphyseal involvement of the femoral head.

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“…This phenomenon can pose challenges in assessing OS and can decrease the sensitivity of diffusion MR. Careful review and correlation of T2W obtained with multiple diffusion weightings and the corresponding ADC map is necessary to avoid misinterpretations 73 …”

Section: Methodsmentioning

confidence: 99%

“…Careful review and correlation of T2W obtained with multiple diffusion weightings and the corresponding ADC map is necessary to avoid misinterpretations. 73 Principle and Application of DCE-MRI in Evaluating Treatment Response of Primary Malignant Bone Tumors.…”

Section: Principles and Applications Of Advanced Diffusionmentioning

confidence: 99%

Imaging Assessment of the Efficacy of Chemotherapy in Primary Malignant Bone Tumors: Recent Advances in Qualitative and Quantitative Magnetic Resonance Imaging and Radiomics

Liu

Duan

Fang

et al. 2023

Magnetic Resonance Imaging

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Pediatric skeletal diffusion-weighted magnetic resonance imaging, part 2: current and emerging applications

Cited by 13 publications

References 78 publications

Preliminary results of abdominal simultaneous multi-slice accelerated diffusion-weighted imaging with motion-correction in patients with cystic fibrosis and impaired compliance

Preliminary results of abdominal simultaneous multi-slice accelerated diffusion-weighted imaging with motion-correction in patients with cystic fibrosis and impaired compliance

Benefits of diffusion-weighted imaging in pediatric acute osteoarticular infections

Imaging Assessment of the Efficacy of Chemotherapy in Primary Malignant Bone Tumors: Recent Advances in Qualitative and Quantitative Magnetic Resonance Imaging and Radiomics

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