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?

Research output: Contribution to journalArticle

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 and methods: 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) = − 5.537:4.521) and 1.348% (CI = − 3.541:6.311) for readers 1 and 2. By Q-ROI, lesion signal change was − 11.03% (CI = − 17.01:- 5.046) and − 5.657% (CI = − 12.36:1.048) 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.

Original languageEnglish (US)
Pages (from-to)1-11
Number of pages11
JournalSkeletal Radiology
DOIs
StateAccepted/In press - Jun 23 2018

Fingerprint

Bone Marrow
Magnetic Resonance Imaging
Confidence Intervals
Sensitivity and Specificity
Students

Keywords

  • 3 Tesla
  • Bone tumor
  • Chemical shift imaging
  • Marrow
  • MRI
  • Opposed-phase

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

@article{8511b97cbaa04f23861a6d3458191294,
title = "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?",
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 and methods: 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) = − 5.537:4.521) and 1.348{\%} (CI = − 3.541:6.311) for readers 1 and 2. By Q-ROI, lesion signal change was − 11.03{\%} (CI = − 17.01:- 5.046) and − 5.657{\%} (CI = − 12.36:1.048) 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.",
keywords = "3 Tesla, Bone tumor, Chemical shift imaging, Marrow, MRI, Opposed-phase",
author = "Neil Kumar and Shivani Ahlawat and Fayad, {Laura M}",
year = "2018",
month = "6",
day = "23",
doi = "10.1007/s00256-018-2999-0",
language = "English (US)",
pages = "1--11",
journal = "Skeletal Radiology",
issn = "0364-2348",
publisher = "Springer Verlag",

}

TY - JOUR

T1 - Chemical shift imaging with in-phase and opposed-phase sequences at 3 T

T2 - what is the optimal threshold, measurement method, and diagnostic accuracy for characterizing marrow signal abnormalities?

AU - Kumar, Neil

AU - Ahlawat, Shivani

AU - Fayad, Laura M

PY - 2018/6/23

Y1 - 2018/6/23

N2 - 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 and methods: 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) = − 5.537:4.521) and 1.348% (CI = − 3.541:6.311) for readers 1 and 2. By Q-ROI, lesion signal change was − 11.03% (CI = − 17.01:- 5.046) and − 5.657% (CI = − 12.36:1.048) 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.

AB - 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 and methods: 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) = − 5.537:4.521) and 1.348% (CI = − 3.541:6.311) for readers 1 and 2. By Q-ROI, lesion signal change was − 11.03% (CI = − 17.01:- 5.046) and − 5.657% (CI = − 12.36:1.048) 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.

KW - 3 Tesla

KW - Bone tumor

KW - Chemical shift imaging

KW - Marrow

KW - MRI

KW - Opposed-phase

UR - http://www.scopus.com/inward/record.url?scp=85048945192&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85048945192&partnerID=8YFLogxK

U2 - 10.1007/s00256-018-2999-0

DO - 10.1007/s00256-018-2999-0

M3 - Article

C2 - 29936558

AN - SCOPUS:85048945192

SP - 1

EP - 11

JO - Skeletal Radiology

JF - Skeletal Radiology

SN - 0364-2348

ER -