Castagnoli Francesca, Dragan Alina, Candito Antonio, Tunariu Nina, Messiou Christina, Koh Dow-Mu
Department of Radiology, Royal Marsden Hospital, Sutton, UK; Division of Radiotherapy and Imaging, The Institute of Cancer Research, Sutton, UK.
Department of Radiology, Royal Marsden Hospital, Sutton, UK; Division of Radiotherapy and Imaging, The Institute of Cancer Research, Sutton, UK.
Magn Reson Imaging. 2025 Apr;117:110331. doi: 10.1016/j.mri.2025.110331. Epub 2025 Jan 22.
Whole-body MRI (WB-MRI) is increasingly used in clinical practice for detection of malignant bone disease. A high relative contrast ratio (RCR) of malignant bone lesions compared with normal bone can improve disease detection in breast, prostate and myeloma malignancies. However, the RCR of malignant bone lesions on T1w, DWI and relative Fat Fraction (rFF) maps derived from Dixon T1w have not been compared.
110 baseline WB-MRI of patients with suspected malignant bone lesions were reviewed retrospectively. On each scan, up to four active bone lesions were identified, one each at the cervicothoracic spine, lumbosacral spine, pelvis and extremity, and their ROI signal intensity measured on rFF, T1w and DWI b = 900. The signal intensity of background bone was measured by placing an ROI on the nearest normal-appearing bone to each lesion, for each sequence. The mean lesion signal-to-background ratio (taken as RCR) for each lesion was calculated. We compared the RCR of bone lesions on rFF, T1w and DWI (Mann-Whitney test).
The median rFF RCR of malignant bone lesions was highest compared with normal bone marrow than that of T1w (p < 0.0001) and DWI (p < 0.0001). There was no significant difference in the median rFF RCR of malignant bone lesions from breast cancer, myeloma and prostate cancer (p > 0.017, Bonferroni correction) or according to their anatomical locations (p > 0.012, Bonferroni correction).
Malignant bone lesion RCR measured by lesion/background signal intensity was higher on rFF than on T1w and DWI b = 900 in patients with prostate, breast and myeloma malignancies, indicating its value for disease detection.
全身磁共振成像（WB-MRI）在临床实践中越来越多地用于检测恶性骨病。与正常骨相比，恶性骨病变具有较高的相对对比率（RCR）可提高乳腺癌、前列腺癌和骨髓瘤恶性肿瘤的疾病检测率。然而，尚未对T1加权成像（T1w）、扩散加权成像（DWI）以及基于狄克逊T1w的相对脂肪分数（rFF）图上恶性骨病变的RCR进行比较。
回顾性分析110例疑似恶性骨病变患者的基线WB-MRI。在每次扫描中，最多识别出四个活跃的骨病变，分别位于颈胸椎、腰骶椎、骨盆和四肢各一个，并在rFF、Tlw和DWI b = 900上测量其感兴趣区（ROI）信号强度。通过在每个病变最近的外观正常的骨上放置ROI来测量每个序列中背景骨的信号强度。计算每个病变的平均病变信号与背景比值（视为RCR）。我们比较了rFF、T1w和DWI上骨病变的RCR（曼-惠特尼检验）。
与正常骨髓相比，恶性骨病变的rFF RCR中位数高于T1w（p < 0.0001）和DWI（p < 0.0001）。乳腺癌、骨髓瘤和前列腺癌的恶性骨病变的rFF RCR中位数或根据其解剖位置无显著差异（p > 0.017，Bonferroni校正）或（p > 0.012，Bonferroni校正）。
在前列腺癌、乳腺癌和骨髓瘤恶性肿瘤患者中，通过病变/背景信号强度测量的恶性骨病变RCR在rFF上高于T1w和DWI b = 900，表明其在疾病检测中的价值。
