Quantifying Bone Marrow Fat Fraction and Iron by <scp>MRI</scp> for Distinguishing Aplastic Anemia from Myelodysplastic Syndromes

Zeng, Z.; Ma, Xiangzheng; Guo, Yifan; Ye, Baodong; Xu, Maosheng; Wang, Wei

doi:10.1002/jmri.27769

Cited by 20 publications

(13 citation statements)

References 40 publications

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“…Compared with other sequences such as T1-in-and-out-of-phase (IOP) MRI, CSE-MRI is a more sophisticated fat quantification approach which corrects for a number of confounding factors including T1 bias, noise bias and eddy currents ( 17 – 19 ). An iterative least-squares decomposition algorithm is used to solve for proton density fat fraction (PDFF) maps enabling the quantitative assessment of fatty lesions, which have been widely applied in the imaging of non-alcoholic fatty liver disease ( 20 , 21 ) as well as bone marrow fat in hematological diseases ( 22 ).…”

Section: Introductionmentioning

confidence: 99%

Quantification of Fat Metaplasia in the Sacroiliac Joints of Patients With Axial Spondyloarthritis by Chemical Shift-Encoded MRI: A Diagnostic Trial

et al. 2022

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ObjectiveTo study the diagnostic performance of chemical shift-encoded MRI (CSE-MRI) in the diagnosis of axial spondyloarthritis (axSpA).MethodsCSE-MRI images were acquired for consecutive patients complaining of back pain as well as healthy volunteers. Proton density fat fraction (PDFF) values were measured independently by two readers. Diagnostic performance of CSE-MRI was analyzed by sensitivity analysis and ROC curve analysis. Logistic regression analysis was employed to investigate the risk factors of extensive fat deposition in the SIJs.ResultsA total of 52 r-axSpA patients, 37 nr-axSpA patients, 24 non-SpA patients and 34 healthy volunteers were included. Mean PDFF values in the SIJs of patients with r-axSpA and nr-axSpA (72.7% and 64.5%) were significantly higher than non-SpA patients and healthy volunteers (56.0% and 57.6%) (p<0.001). By defining extensive fat deposition in the SIJs as ≥8 ROIs with PDFF values over 70%, its sensitivity and specificity in diagnosing axSpA reached 72.47% and 86.21%%. By joining bone marrow edema (BME) with ≥8 ROIs (PDFF>70%), 22 (24.71%) and 23 (25.84%) more axSpA patients were classified as SIJ MRI (+) by reader 1 and 2, but specificities decreased by 15.52% and 10.34%. Multivariate logistic regression analysis confirmed longer disease duration as the independent risk factor of extensive fat deposition in SIJs (OR=1.15, 95%CI[1.03, 1.32]), while bDMARDs medication was a protective factor (OR=0.15, 95%CI[0.04, 0.51]).ConclusionCSE-MRI is a reliable tool to quantitively assess the fat metaplasia in the SIJs of axSpA patients. Extensive fat deposition in the SIJs could add incremental diagnostic value to BME, but at the cost of decreased specificities.

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Section: Introductionmentioning

confidence: 99%

Quantification of Fat Metaplasia in the Sacroiliac Joints of Patients With Axial Spondyloarthritis by Chemical Shift-Encoded MRI: A Diagnostic Trial

et al. 2022

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“…At the same time, various physiological and pathological changes of bone marrow are closely related to fat content. Therefore, the quantification of fat content in bone marrow is of great clinical significance for evaluating the impact of various physiological and pathological processes on spinal bone marrow and screening of disease-related information ( 13 ). When compared with yellow bone marrow, red bone marrow contains a lower fraction of fat and a higher fraction of water ( 10 ).…”

Section: Discussionmentioning

confidence: 99%

The quantitative parameters derived from IDEAL-IQ in the lumbar vertebrae of healthy children: a pilot study of bone development

Yang,

Sun,

Yang

et al. 2024

Quant Imaging Med Surg

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Background Early childhood bone development affects that of bone disease in adolescence and adulthood. Many diseases can affect the cancellous bone or bone marrow. Therefore, it is of great significance to quantify the bone development of healthy children. The evaluation methods of bone development include bone age (BA) assessment and dual-energy X-ray bone mineral densitometry (DXA), both of which have strong subjectivity. The present study was conducted to improve our understanding of the bone development of healthy children using the quantitative parameters derived from iterative decomposition of water and fat with echo asymmetry and least squares estimation quantification (IDEAL-IQ) sequence. Methods Our study enrolled healthy children between January 2022 to December 2022 consecutively in Children’s Hospital of Shanxi. The inclusion criteria were as follows: (I) age ≤18 years; (II) no contraindications (surgical and interventional devices for ferromagnetic materials, cardiac implantable electronic devices, cochlear implants, insulin pumps, dental implants containing metal or alloy) to magnetic resonance imaging (MRI) scan. The exclusion criteria were as follows: (I) previous malignant disease, (II) previous chemoradiotherapy, (III) previous spine surgery, (IV) previous or acute vertebral compression fracture, (V) artifacts present in images. Participants underwent MRI scans using IDEAL-IQ sequence in the lumbar vertebrae. The IDEAL-IQ parameters [proton density fat fraction (PDFF), 1/T2* (R2*)] were obtained. The factor analysis of variance was applied to compare the differences of PDFF and R2* in different lumbar vertebral groups. The Kruskal-Wallis H test or Mann-Whitney U test was applied to compare the differences of quantitative data among different gender or age groups. Spearman correlation analysis was applied to study the relationship among the age, PDFF, and R2*. Results A total of 145 participants (76 males, 69 females) were evaluated. There were no significant differences in PDFF and R2* of different lumbar vertebrae (P PDFF =0.338, P R2* =0.868). The average age was 36 [13–72] months. They were assigned into 4 groups (0–11, 12–35, 36–71, and 72–144 months). As the age increased, the average PDFF and R2* both increased significantly (r PDFF =0.659, r R2* =0.359, P<0.001). There were significant statistical differences in PDFF and R2* between the 4 age groups (Z PDFF =46.651, Z R2* =27.537, P<0.001). Moreover, the PDFF was also positively correlated with R2* (r=0.576, P<0.001). No association was found between the gender and PDFF, R2* (P PDFF =0.949, P R2* =0.177). Conclusions The quantitative parameters derived from IDEAL-IQ in t...

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“…This index was examined for osteoporosis diagnosis and the differentiation of aplastic anemia and myelodysplastic syndrome. 37 Nevertheless, the diagnostic value of R2* in bone marrow lesions remains controversial. Liu et al investigated the quantitative MRI assessment of 83 patients with low back pain-results showed that R2* had a lower AUC than FF in diagnosing the progression of osteoporosis and osteopenia, making it difficult to use it as an independent diagnostic indicator for osteoporosis.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, R2* (equivalent to 1/T2*) was correlated with the microarchitectural structure of the bone marrow. This index was examined for osteoporosis diagnosis and the differentiation of aplastic anemia and myelodysplastic syndrome 37 . Nevertheless, the diagnostic value of R2* in bone marrow lesions remains controversial.…”

Section: Discussionmentioning

confidence: 99%

Quantitative Analysis of Whole‐Body MRI for Accessing the Degree of Diffuse Infiltration Patterns and Identifying High Risk Cases of Newly Diagnosed Multiple Myeloma

Sun,

Wang,

Wang

et al. 2023

Magnetic Resonance Imaging

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BackgroundAccurate identification of high‐risk multiple myeloma (HRMM) is important for prognostication. The degree of diffuse infiltration patterns on magnetic resonance imaging (MRI) is associated with patient prognosis in multiple myeloma. However, objective indexes to determine the degree of diffuse infiltration patterns are unavailable.PurposeTo investigate whether qualitative and quantitative evaluations of diffuse infiltration patterns on MRI could identify HRMM.Study TypeRetrospective.SubjectsTotally, 180 patients (79 HRMM and 101 standard‐risk MM) were assessed. The presence of del(17p), t(4;14), t(14;16), t(14;20), gain 1q, and/or p53 mutations was considered to indicate HRMM.Field Strength/Sequence3.0 T/diffusion‐weighted whole‐body imaging with background body signal suppression (DWIBS), modified Dixon chemical‐shift imaging Quant (mDIXON Quant), and short TI inversion recovery (STIR).AssessmentQualitative analysis involved assessing the degree of diffuse marrow infiltration (mild, moderate, or severe), and quantitative analysis involved evaluating apparent diffusion coefficient (ADC), fat fraction (FF), and T2* values. Clinical data such as sex, age, hemoglobin, serum albumin, serum calcium, serum creatinine, serum lactate dehydrogenase, β2‐microglobulin, and bone marrow plasma cells (BMPCs) were also included.Statistical TestsUnivariate and multivariate analyses, receiver operating characteristic (ROC) curve. P < 0.05 was considered statistically significant.ResultsThe high‐risk group had significantly higher ADC and T2* and lower FF compared with the standard‐risk group. Multivariate analysis indicated BMPCs as a significant independent risk factor for HRMM (odds ratio (OR) = 1.019, 95% CI 1.004–1.033), while FF was a significant independent protective factor associated with HRMM (OR = 0.972, 95% CI 0.946–0.999). The combination of BMPCs and FF achieved the highest areas under the curve (AUC) of 0.732, with sensitivity and specificity of 70.9% and 68.3%, respectively.Data ConclusionCompared with qualitative analysis, FF value was independently associated with HRMM. The quantitative features of diffuse marrow infiltration on MRI scans are more effective in detecting HRMM.Level of Evidence3Technical EfficacyStage 2

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Quantifying Bone Marrow Fat Fraction and Iron by MRI for Distinguishing Aplastic Anemia from Myelodysplastic Syndromes

Cited by 20 publications

References 40 publications

Quantification of Fat Metaplasia in the Sacroiliac Joints of Patients With Axial Spondyloarthritis by Chemical Shift-Encoded MRI: A Diagnostic Trial

Quantification of Fat Metaplasia in the Sacroiliac Joints of Patients With Axial Spondyloarthritis by Chemical Shift-Encoded MRI: A Diagnostic Trial

The quantitative parameters derived from IDEAL-IQ in the lumbar vertebrae of healthy children: a pilot study of bone development

Quantitative Analysis of Whole‐Body MRI for Accessing the Degree of Diffuse Infiltration Patterns and Identifying High Risk Cases of Newly Diagnosed Multiple Myeloma

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