Original Research

Differentiation of focal indeterminate marrow abnormalities with multiparametric MRI

Jun Seung Baik MD

Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea

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Joon-Yong Jung MD,

Corresponding Author

Joon-Yong Jung MD

[email protected]

Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea

Address reprint requests to: J.-Y.J., Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, South Korea. E-mail: [email protected]Search for more papers by this author

Won-Hee Jee MD,

Won-Hee Jee MD

Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea

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Chang-Woo Chun MD,

Chang-Woo Chun MD

Department of Radiology, Uijeongbu St. Mary's Hospital

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Sun Ki Kim MD,

Sun Ki Kim MD

Incheon St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea

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Seung Han Shin MD,

Seung Han Shin MD

Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea

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Yang Guk Chung MD,

Yang Guk Chung MD

Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea

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Chan-Kwon Jung MD,

Chan-Kwon Jung MD

Department of Pathology, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea

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Stephan Kannengiesser PhD,

Stephan Kannengiesser PhD

Siemens Healthcare, Erlangen, Germany

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YoHan Sohn PhD,

YoHan Sohn PhD

Siemens Healthcare, Seoul, Republic of Korea

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Jun Seung Baik MD,

Jun Seung Baik MD

Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea

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Joon-Yong Jung MD,

Corresponding Author

Joon-Yong Jung MD

[email protected]

Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea

Won-Hee Jee MD,

Won-Hee Jee MD

Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea

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Chang-Woo Chun MD,

Chang-Woo Chun MD

Department of Radiology, Uijeongbu St. Mary's Hospital

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Sun Ki Kim MD,

Sun Ki Kim MD

Incheon St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea

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Seung Han Shin MD,

Seung Han Shin MD

Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea

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Yang Guk Chung MD,

Yang Guk Chung MD

Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea

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Chan-Kwon Jung MD,

Chan-Kwon Jung MD

Department of Pathology, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea

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Stephan Kannengiesser PhD,

Stephan Kannengiesser PhD

Siemens Healthcare, Erlangen, Germany

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YoHan Sohn PhD,

YoHan Sohn PhD

Siemens Healthcare, Seoul, Republic of Korea

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First published: 09 November 2016

https://doi.org/10.1002/jmri.25536

Citations: 20

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Abstract

Purpose

To explore magnetic resonance imaging (MRI) parameters from intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI), multiecho Dixon imaging (ME-Dixon), and dynamic contrast-enhanced imaging (DCE) for differentiating focal indeterminate marrow abnormalities

Materials and Methods

Forty-two patients with 14 benign and 28 malignant focal marrow abnormalities were included. The following were independently analyzed by two readers: signal intensity (SI), contour, and margin on conventional MR images; SI on b-800 images (SI_b-800), apparent diffusion coefficient (ADC), IVIM parameters (D_slow, D_fast, and f), fat fraction (Ff), and DCE parameters (time-to-signal intensity curve pattern, iAUC, K^trans, k_ep, and v_e). The MR characteristics and parameters from benign and malignant lesions were compared with a chi-squared test and the Mann–Whitney U-test, respectively. The area under receiver operating characteristic (ROC) curves (AUC) of each sequence were also compared. Interobserver agreements were assessed with Cohen's κ, and intraclass correlation coefficient (ICC).

Results

ADC, D_slow, and Ff demonstrated a significant difference between benign and malignant marrow abnormalities for both readers (P < 0.001). SI_b-800 and perfusion-related parameters from IVIM-DWI and DCE were not significantly different between the two groups (P = 0.145, 0.439, and 0.337 for reader 1, P = 0.378, 0.368, and 0.343 for reader 2, respectively). The AUCs of ADC, D_slow, and Ff were significantly higher for differentiating indeterminate marrow abnormalities in both readers (P < 0.001). Interobserver agreements were substantial in SI_b-800, and ICCs were almost perfect for ADC, D_slow, f, and Ff, and substantial for iAUC, k_ep, K^trans, v_e, and D_fast.

Conclusion

ADC, D_slow, and Ff may provide information for differentiating focal indeterminate abnormalities.

Level of Evidence: 3

Technical Efficacy: Stage 2

J. MAGN. RESON. IMAGING 2017;46:49–60

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July 2017

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Differentiation of focal indeterminate marrow abnormalities with multiparametric MRI

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Materials and Methods

Results

Conclusion

References

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Differentiation of focal indeterminate marrow abnormalities with multiparametric MRI

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