Bray Timothy J P, Singh Saurabh, Latifoltojar Arash, Rajesparan Kannan, Rahman Farzana, Narayanan Priya, Naaseri Sahar, Lopes Andre, Bainbridge Alan, Punwani Shonit, Hall-Craggs Margaret A
Centre for Medical Imaging, University College London, London, United Kingdom.
Cancer Research UK and UCL Clinical Trials Centre, London, United Kingdom.
PLoS One. 2017 Jul 3;12(7):e0180562. doi: 10.1371/journal.pone.0180562. eCollection 2017.
To determine which of four Dixon image types [in-phase (IP), out-of-phase (OP), fat only (FO) and water-only (WO)] is most sensitive for detecting multiple myeloma (MM) focal lesions on whole body MRI (WB-MRI) images.
Thirty patients with clinically-suspected MM underwent WB-MRI at 3 Tesla. Unenhanced IP, OP, FO and WO Dixon images were generated and read by four radiologists. On each image type, each radiologist identified and labelled all visible myeloma lesions in the bony pelvis. Each identified lesion was compared with a reference standard consisting of pre- and post-contrast Dixon and diffusion weighted imaging (read by a further consultant radiologist) to determine whether the lesion was truly positive. Lesion count, true positives, sensitivity, and positive predictive value were compared across the four Dixon image types.
Lesion count, true positives, sensitivity and confidence scores were all significantly higher on FO images than on IP images (p>0.05).
FO images are more sensitive than other Dixon image types for MM focal lesions, and should be preferentially read by radiologists to improve diagnostic accuracy and reporting efficiency.
确定四种 Dixon 图像类型（同相位（IP）、反相位（OP）、仅脂肪（FO）和仅水（WO））中哪一种对全身 MRI（WB-MRI）图像上多发性骨髓瘤（MM）局灶性病变的检测最为敏感。
30 例临床疑似 MM 的患者在 3 特斯拉磁场下接受 WB-MRI 检查。生成未增强的 IP、OP、FO 和 WO Dixon 图像，并由四名放射科医生进行解读。在每种图像类型上，每位放射科医生在骨盆骨中识别并标记所有可见的骨髓瘤病变。将每个识别出的病变与由对比剂前后 Dixon 图像和扩散加权成像组成的参考标准（由另一位放射科顾问医生解读）进行比较，以确定该病变是否为真正的阳性病变。比较四种 Dixon 图像类型的病变数量、真阳性、敏感性和阳性预测值。
FO 图像上的病变数量、真阳性、敏感性和可信度评分均显著高于 IP 图像（p>0.05）。
FO 图像对 MM 局灶性病变比其他 Dixon 图像类型更敏感，放射科医生应优先解读 FO 图像以提高诊断准确性和报告效率。
