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Bone marrow magnetic resonance imaging of the clivus in pediatric leukemia patients and normal controls

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Abstract

Purpose

An MRI-based pre-test to determine the probability of pediatric leukemia prior to bone marrow aspiration would be useful to prevent unnecessary exposure to this invasive test. We aimed to evaluate the clivus-to-pons signal intensity ratio (CPR) and visual scoring (VS) on T1-weighted images (T1WI) and diffusion-weighted images (DWI) to distinguish pediatric leukemia patients from normal controls.

Materials and methods

We retrospectively reviewed 1.5-T brain MR images of 13 consecutive leukemia patients (3 girls, 10 boys; mean age, 8.23 years; range, 1–17 years) and 40 age- and gender-matched normal controls. We evaluated differences between leukemia patients and normal controls using Wilcoxon rank-sum and Mann–Whitney U tests with respect to the following parameters: (1) CPR on T1WI (CPRT1WI); (2) CPR on DWI (CPRDWI); (3) VS on T1WI (VST1WI); and (4) VS on DWI (VSDWI).

Results

The CPRT1WI values for leukemia patients and normal controls were 0.77 ± 0.12 and 1.39 ± 0.47, respectively (P < 0.001). The corresponding CPRDWI values were 1.03 ± 0.38 and 0.50 ± 0.17, respectively (P < 0.001). VST1WI and VSDWI were significantly different between the groups (P < 0.001 for both).

Conclusion

MRI-based quantitative and qualitative analyses of clival bone marrow on T1WI and DWI can distinguish pediatric leukemia patients from normal subjects.

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Conflict of interest

Prof. Kazumoto Iijima has a research funding from Pfizer Japan Inc. The other authors declare that they have no conflict of interest.

Ethical statements

Our institutional review board (IRB) approved this retrospective study. The IRB approval number was No. 1480. Written informed consent for all patients was waived by our IRB because of the retrospective study. The entire patient records/information were anonymized and de-identified prior to analysis.

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Authors and Affiliations

  1. Department of Radiology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Hyogo, Japan

    Tatsuya Nishii, Atsushi K. Kono & Kazuro Sugimura

  2. Department of Radiology, Kobe Children’s Hospital, Kobe, Hyogo, Japan

    Yoshinobu Akasaka

  3. Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan

    Takeshi Mori, Akira Hayakawa & Kazumoto Iijima

Authors
  1. Tatsuya Nishii
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  2. Atsushi K. Kono
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  3. Yoshinobu Akasaka
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  4. Takeshi Mori
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  5. Akira Hayakawa
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  6. Kazumoto Iijima
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  7. Kazuro Sugimura
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Corresponding author

Correspondence to Tatsuya Nishii.

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Nishii, T., Kono, A.K., Akasaka, Y. et al. Bone marrow magnetic resonance imaging of the clivus in pediatric leukemia patients and normal controls. Jpn J Radiol 33, 146–152 (2015). https://doi.org/10.1007/s11604-015-0394-5

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  • DOI: https://doi.org/10.1007/s11604-015-0394-5

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