Abstract
Background
Pediatric bone marrow assessment by MRI is challenging and primarily experiential and qualitative, with a paucity of clinically useful quantitative imaging techniques.
Objective
MRI fat fraction (MRI-FF) is a technique used to quantify the degree of fat in other organ systems. The purpose of this study was to assess whether MRI-FF accurately measures bone marrow composition.
Materials and methods
This two-part study included a validation phase, followed by an application phase. For the validation phase, the MRI-FF of piglet bones (6 long bones, 8 axial bones) was performed at 1.5 tesla (T) and 3.0 T, and correlated to the histological fat fraction (H-FF). We used Bland–Altman plots to compare MRI-FF at 1.5 tesla T and 3.0 T. For the application phase, five children with malignant marrow disease were recruited along with seven age- and gender-matched control subjects. The MRI-FF in the children was correlated to the H-FF. Boxplots were used to compare the MRI-FF of patients and control subjects.
Results
For the validation animal study, the MRI-FF of piglet bones at both 1.5 T and 3.0 T demonstrated moderate positive correlation to H-FF (r=0.41 and 0.42, respectively). MRI-FF at 1.5 T and 3.0 T were in good agreement, on average 7.7% apart. For the application phase, we included 5 children (4 with leukemia, 1 rhabdomyosarcoma) with median age 7 years, range (3–10 years). All children had MRI-FF and H-FF below 10%. The MRI-FF in patients (3.8±1.2) was significantly lower than that of control subjects (46.1±12.3%) (P<0.01).
Conclusion
MRI-FF is a valid technique to assess bone marrow fat fraction at both 1.5 T and 3.0 T. The MRI-FF in children with malignant marrow processes is significantly lower than in control subjects with normal marrow.
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References
Chan BY, Gill KG, Rebsamen SL, Nguyen JC (2016) MR imaging of pediatric bone marrow. Radiographics 36:1911–1930
Shiga NT, Del Grande F, Lardo O, Fayad LM (2013) Imaging of primary bone tumors: determination of tumor extent by non-contrast sequences. Pediatr Radiol 43:1017–1023
Bracken J, Nandurkar D, Radhakrishnan K, Ditchfield M (2013) Normal paediatric bone marrow: magnetic resonance imaging appearances from birth to 5 years. J Med Imaging Radiat Oncol 57:283–291
Burdiles A, Babyn PS (2009) Pediatric bone marrow MR imaging. Magn Reson Imaging Clin N Am 17:391–409
Matcuk GR Jr, Siddiqi I, Cen S et al (2016) Bone marrow cellularity MRI calculation and correlation with bone marrow biopsy. Clin Imaging 40:392–397
Karampinos DC, Ruschke S, Dieckmeyer M et al (2018) Quantitative MRI and spectroscopy of bone marrow. J Magn Reson Imaging 47:332–353
Kumar NM, Ahlawat S, Fayad LM (2018) 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? Skelet Radiol 47:1661–1671
Deng J, Fishbein MH, Rigsby CK et al (2014) Quantitative MRI for hepatic fat fraction and T2* measurement in pediatric patients with non-alcoholic fatty liver disease. Pediatr Radiol 44:1379–1387
Bydder M, Yokoo T, Hamilton G et al (2008) Relaxation effects in the quantification of fat using gradient echo imaging. Magn Reson Imaging 26:347–359
Yokoo T, Bydder M, Hamilton G et al (2009) Nonalcoholic fatty liver disease: diagnostic and fat-grading accuracy of low-flip-angle multiecho gradient-recalled-echo MR imaging at 1.5 T. Radiology 251:67–76
Friebert SE, Shepardson LB, Shurin SB et al (1998) Pediatric bone marrow cellularity: are we expecting too much? J Pediatr Hematol Oncol 20:439–443
Thiele J, Kvasnicka HM, Facchetti F et al (2005) European consensus on grading bone marrow fibrosis and assessment of cellularity. Haematologica 90:1128–1132
Yoo HJ, Hong SH, Kim DH et al (2017) Measurement of fat content in vertebral marrow using a modified Dixon sequence to differentiate benign from malignant processes. J Magn Reson Imaging 45:1534–1544
Kuhn JP, Hernando D, Meffert PJ et al (2013) Proton-density fat fraction and simultaneous R2* estimation as an MRI tool for assessment of osteoporosis. Eur Radiol 23:3432–3439
Zhang C, Slade JM, Miller F, Modlesky CM (2020) Quantifying bone marrow fat using standard T1-weighted magnetic resonance images in children with typical development and in children with cerebral palsy. Sci Rep 10:1–8
Gee CS, Nguyen JT, Marquez CJ et al (2015) Validation of bone marrow fat quantification in the presence of trabecular bone using MRI. J Magn Reson Imaging 42:539–544
Pichardo JC, Milner RJ, Bolch WE (2011) MRI measurement of bone marrow cellularity for radiation dosimetry. J Nucl Med 52:1482–1489
Percival ME, Lai C, Estey E, Hourigan CS (2017) Bone marrow evaluation for diagnosis and monitoring of acute myeloid leukemia. Blood Rev 31:185–192
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Samet, J.D., Deng, J., Schafernak, K. et al. Quantitative magnetic resonance imaging for determining bone marrow fat fraction at 1.5 T and 3.0 T: a technique to noninvasively assess cellularity and potential malignancy of the bone marrow. Pediatr Radiol 51, 94–102 (2021). https://doi.org/10.1007/s00247-020-04809-8
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DOI: https://doi.org/10.1007/s00247-020-04809-8