Chemical shift imaging with in-phase and opposed-phase sequences at 3 T: what is the optimal threshold, measurement method, and diagnostic accuracy for characterizing marrow signal abnormalities?
Skeletal Radiol
; 47(12): 1661-1671, 2018 Dec.
Article
em En
| MEDLINE
| ID: mdl-29936558
ABSTRACT
OBJECTIVE:
To determine the threshold signal drop on 3-T chemical shift imaging (CSI), with in-phase (IP) and opposed-phase (OP) sequences, for accurately identifying bone marrow replacement with 100% sensitivity, and determine a clinically useful measurement method for deriving such a threshold. MATERIALS ANDMETHODS:
From a convenience series of 157 MRIs, 36 cases with histologically proven marrow-replacing lesions and 22 sites of red marrow (histologically proven (2) or with minimum 6-month stability) with 3-Tesla CSI were included. Two musculoskeletal radiologists performed two measurement methods (first multiple algorithmic ROIs at the top, middle, and bottom of lesions (M-ROI); second an ROI was drawn where there appeared to be the least opposed-phase signal reduction qualitatively/visually (Q-ROI)). Lesional and red marrow signal change (%,[(IP-OP)signal/IP signal]*100) was determined. Statistical analyses included Student's t test, Cohen's kappa, and receiver operator characteristic curve generation.RESULTS:
By M-ROI, lesion signal change was - 0.508% (confidence interval (CI) = - 5.5374.521) and 1.348% (CI = - 3.5416.311) for readers 1 and 2. By Q-ROI, lesion signal change was - 11.03% (CI = - 17.01- 5.046) and - 5.657% (CI = - 12.361.048) for readers 1 and 2. For all M-ROI and Q-ROI measurement strategies, signal change between lesional tissue and red marrow was significantly different (p < 0.0001). QROI produced the best composite sensitivities and specificities with a maximized Youden index of 0.955-1. A threshold signal drop of 25% with Q-ROI produced at least 100%/86% sensitivity/specificity for both readers for identifying marrow replacement.CONCLUSIONS:
For 3-T CSI, a single visually targeted measurement using a 25% threshold is accurate for identifying marrow-replacing lesions.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
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Tipos_de_cancer
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Outros_tipos
Base de dados:
MEDLINE
Assunto principal:
Doenças da Medula Óssea
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Neoplasias Ósseas
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Imageamento por Ressonância Magnética
Tipo de estudo:
Diagnostic_studies
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Observational_studies
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Prognostic_studies
Limite:
Adolescent
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Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Skeletal Radiol
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Estados Unidos