Role of diffusion-weighted imaging for detecting bone marrow infiltration in skull in children with acute lymphoblastic leukemia

Cao, Wenxi; Liang, Changhong; Gen, Yungan; Wang, Chen; Zhao, Cailei; Sun, Lianwen

doi:10.5152/dir.2016.15167

Cited by 22 publications

(10 citation statements)

References 26 publications

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“… 3,4 However, DWI is most often referred for intracranial pathologies. 5 Usage of DWI in the extracranial sites such as abdomen and pelvis is also encouraging and has become a routine sequence in oncologic settings. 6 This feature can be made use of in differentiating benign and malignant lesions and assessing treatment.…”

Section: Discussionmentioning

confidence: 99%

Role of diffusion-weighted MRI in differentiating benign from malignant bone tumors

2019

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Objective: To evaluate the role of diffusion-weighted MRI in differentiating benign from malignant primary bone tumors. To know the sensitivity and specificity of diffusion weighted MRI and calculating apparent diffusion coefficient (ADC) cutoff in differentiating benign from malignant primary bone tumors. Methods and materials : This is a prospective observational study of 50 patients, who were clinically or radiologically suspected with primary bone tumor and referred to the Department of Radiodiagnosis, for radiography or for MRI. These patients underwent routine MRI sequences including diffusion-weighted MRI with b-values of 0, 500 and 1000, followed by pathological examination supplemented by immunohistochemistry (wherever necessary). Hematological malignancies, recently biopsied cases and recurrent cases were excluded from the study. Results: Out of 50 patients with suspected bone tumors, 15 were benign (and tumor like lesions) and 35 were malignant primary bone tumors. The most common age group involved for both benign and malignant primary bone tumors was 11–20 years (23 cases—46%). In our study, total number of affected males were 27 (54%) and total number of affected females were 23 (46%) with M:F ratio of 1.17:1. In this study 72% lesions had appendicular bone involvement and 28% had axial bone involvement. 94.3% of malignant lesions showed restriction on diffusion-weighted imaging (DWI) and in 80 % of benign lesions restriction was absent on DWI which was statistically significant. Mean ADC levels in malignant lesions was 1.092 ± 0.497 and in benign lesions was 1.62 ± 0.596 which was statistically significant. Chondrosarcoma had highest ADC and Ewing’s sarcoma had lowest ADC values in malignant lesions. Chondroblastoma had highest ADC and Osteomyelitis had lowest ADC values in benign lesions. ADC value of 1.31 had highest sensitivity and specificity to differentiate between benign and malignant lesions. Conclusion: DWI is helpful in differentiating malignant from benign bone tumors and tumor like lesions with diffusion restriction favoring malignancy. Inspite of some overlap, ADC values of benign and malignant bone tumors are different and measurement of ADC values improves the accuracy of the diagnosis of bone tumors and tumor like lesions. Calculation of ADC may also be used as baseline reference to assess response to treatment in future or for follow up. Advances in knowledge: DWI imaging (and ADC values) has been extensively used in neuroimaging. Extension of this application to musculoskeletal–oncologic imaging is not so well studied. Apart from differentiating benign from malignant lesions which is the main focus of this study, assessment of response to treatment by ADC values may be possible in near future.

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Section: Discussionmentioning

confidence: 99%

Role of diffusion-weighted MRI in differentiating benign from malignant bone tumors

2019

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“…Nishi et al were the first to describe the successful application of DWI to predict bone marrow infiltration in pediatric patients with different leukemia subtypes, using the clivus‐to‐pons signal intensity ratios . Cao et al reported the successful use of DWI to capture treatment response in pediatric ALL patients, based on normalization of ADC values measured in the skull . Finally, Niu et al investigated the predictive value of pretherapeutic intravoxel‐incoherent motion (IVIM) MRI—a variation of DWI that enables the assessment of the perfusion component in addition to true molecular diffusion—in patients with AML.…”

Section: Leukemiamentioning

confidence: 99%

MRI and PET/MRI in hematologic malignancies

Mayerhoefer

Archibald

Messiou

et al. 2019

Magnetic Resonance Imaging

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“…Ein leukämisches Infiltrat weist in MRT-Aufnahmen eine T1w Hypointensität und eine variable T2w Signalintensität mit leichter Kontrastmittelanreicherung auf [28,29]. Eine Diffusionsrestriktion kann vorliegen und stellt ein hilfreiches Bildgebungsmerkmal für die Beurteilung des therapeutischen Ansprechens dar [31]. In CT-Aufnahmen ohne Kontrastmittelgabe erscheinen granulozytäre Sarkome iso-oder hyperdens zur Muskulatur.…”

Section: Merkeunclassified

Kraniofaziale Manifestationen von systemischen Erkrankungen: CT- und MRT-Befunde

Arasa¹,

Chapman²,

Kuno³

et al. 2019

Neuroradiol Scan

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Many systemic diseases or conditions can affect the maxillofacial bones; however, they are often overlooked or incidentally found at routine brain or head and neck imaging performed for other reasons. Early identification of some conditions may significantly affect patient care and alter outcomes. Early recognition of nonneoplastic hematologic disorders, such as thalassemia and sickle cell disease, may help initiate earlier treatment and prevent serious complications. The management of neoplastic diseases such as lymphoma, leukemia, or Langerhans cell histiocytosis may be different if diagnosed early, and metastases to the maxillofacial bones may be the first manifestation of an otherwise occult neoplasm. Endocrinologic and metabolic disorders also may manifest with maxillofacial conditions. Earlier recognition of osteoporosis may alter treatment and prevent complications such as insufficiency fractures, and identification of acromegaly may lead to surgical treatment if there is an underlying growth hormone-producing adenoma. Bone dysplasias sometimes are associated with skull base foraminal narrowing and subsequent involvement of the cranial nerves. Inflammatory processes such as rheumatoid arthritis and sarcoidosis may affect the maxillofacial bones, skull base, and temporomandibular joints. Radiologists should be familiar with the maxillofacial computed tomographic and magnetic resonance imaging findings of common systemic disorders because these may be the first manifestations of an otherwise unrevealed systemic process with potential for serious complications.

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Role of diffusion-weighted imaging for detecting bone marrow infiltration in skull in children with acute lymphoblastic leukemia

Cited by 22 publications

References 26 publications

Role of diffusion-weighted MRI in differentiating benign from malignant bone tumors

Role of diffusion-weighted MRI in differentiating benign from malignant bone tumors

MRI and PET/MRI in hematologic malignancies

Kraniofaziale Manifestationen von systemischen Erkrankungen: CT- und MRT-Befunde

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