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28.11.2022 | Scientific Article

Detection of bone marrow metastases in children and young adults with solid cancers with diffusion-weighted MRI

verfasst von: Ali Rashidi, Lucia Baratto, Praveen Jayapal, Ashok Joseph Theruvath, Elton Benjamin Greene, Rong Lu, Sheri L. Spunt, Heike E. Daldrup-Link

Erschienen in: Skeletal Radiology

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Abstract

Objective

To compare the diagnostic accuracy of diffusion-weighted (DW)-MRI with b-values of 50 s/mm2 and 800 s/mm2 for the detection of bone marrow metastases in children and young adults with solid malignancies.

Methods

In an institutional review board-approved prospective study, we performed 51 whole-body DW-MRI scans in 19 children and young adults (14 males, 5 females; age range: 1–25 years) with metastasized cancers before (n = 19 scans) and after (n = 32 scans) chemotherapy. Two readers determined the presence of focal bone marrow lesions in 10 anatomical areas. A third reader measured ADC and SNR of focal lesions and normal marrow. Simultaneously acquired 18F-FDG-PET scans served as the standard of reference. Data of b = 50 s/mm2 and 800 s/mm2 images were compared with the Wilcoxon signed-rank test. Inter-reader agreement was evaluated with weighted kappa statistics.

Results

The SNR of bone marrow metastases was significantly higher compared to normal bone marrow on b = 50 s/mm2 (mean ± SD: 978.436 ± 1239.436 vs. 108.881 ± 109.813, p < 0.001) and b = 800 s/mm2 DW-MRI (499.638 ± 612.721 vs. 86.280 ± 89.120; p < 0.001). On 30 out of 32 post-treatment DW-MRI scans, reconverted marrow demonstrated low signal with low ADC values (0.385 × 10−3 ± 0.168 × 10−3mm2/s). The same number of metastases (556/588; 94.6%; p > 0.99) was detected on b = 50 s/mm2 and 800 s/mm2 images. However, both normal marrow and metastases exhibited low signals on ADC maps, limiting the ability to delineate metastases. The inter-reader agreement was substantial, with a weighted kappa of 0.783 and 0.778, respectively.

Conclusion

Bone marrow metastases in children and young adults can be equally well detected on b = 50 s/mm2 and 800 s/mm2 images, but ADC values can be misleading.
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Metadaten
Titel
Detection of bone marrow metastases in children and young adults with solid cancers with diffusion-weighted MRI
verfasst von
Ali Rashidi
Lucia Baratto
Praveen Jayapal
Ashok Joseph Theruvath
Elton Benjamin Greene
Rong Lu
Sheri L. Spunt
Heike E. Daldrup-Link
Publikationsdatum
28.11.2022
Verlag
Springer Berlin Heidelberg
Erschienen in
Skeletal Radiology
Print ISSN: 0364-2348
Elektronische ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-022-04240-0

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