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Role of Diffusion MRI in Differentiation of Various Bone Marrow Lesions

Observational Diffusion MRI Bone Marrow Disease

For patients and families

In plain language

An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.

What is being studied
This is an observational study: the protocol does not assign a study treatment.
Who it may be relevant to
Registry conditions: Diffusion MRI, Bone Marrow Disease. Basic parameters: 20 years — 60 years · All.
What needs checking
Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
Where it takes place
Center list to be confirmed — check the primary protocol.
Next step
Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
Official title

Role of MRI Diffusion in Differentiation Between Various Vertebral Bone Marrow Pathological Lesions. .

Overview

Bone marrow lesions are common, and imaging findings are associated with various aetiologies, as compared to conventional radiography and computed tomography (CT), MRI is a better non-invasive imaging modality to evaluate vertebral bone marrow, due to better soft-tissue contrast, so the aim of our study is the use of MRI diffusion in differentiating various vertebral bone marrow pathological lesions.

Detailed description

Bone marrow lesions are common, and imaging findings are associated with various aetiologies, such as degenerative, infectious, traumatic, malignant, metabolic, and haematopoietic .

As compared to conventional radiography and computed tomography (CT), MRI is a better non-invasive imaging modality to evaluate vertebral bone marrow, due to better soft-tissue contrast as well as being non-ionising in nature .

Although conventional MRI is essential for anatomical visualization and lesion detection in bone marrow pathologies ,but it often insufficient in distinguishing different vertebral bone marrow lesions, due to overlapping imaging features and often due to coexistence of bone marrow oedema that can be caused by fractures, infection, and bone marrow hyperplasia, thus reducing the specificity of conventional sequences .

MRI diffusion provides complementary information about tissue microstructure and cellular .it exploits the translational mobility of water molecules to obtain information on the microscopic behaviour of the tissues.

On the other hand, apparent diffusion coefficient (ADC) values provide quantitative measure of Brownian movement with low ADC values implying restricted diffusion and high values being a measure of free diffusion.

Therefore, DWI provides both qualitative and quantitative functional information concerning the microscopic movements of water at the cellular level. The benefits of DWI comprise a small scanning period that allows it to be easily included in the routine imaging protocols .

For example, In healthy bone marrow, water diffusion is relatively unrestricted due to its cellularity and vascularity, while pathologies such as metastatic disease or myelofibrosis typically exhibit restricted diffusion.

Diffusion MRI can also distinguish bone marrow edema like acute injury or inflammation, from infiltrative diseases such as multiple myeloma. Edema typically shows higher ADC values due to the increased water content, whereas infiltrative diseases reduce diffusion, resulting in lower ADC values.

These examples illustrate how MRI diffusion can differentiate various vertebral bone marrow pathological lesions.

Primary outcome measures

  • Evaluation of the efficacy of MRI diffusion in differentiation between Various Vertebral bone marrow pathological lesions. . [Time frame: Baseline]

Eligibility criteria

Inclusion criteria

  • All adult patients with vertebral lesions Clinically suspected or diagnosed by other modalities as X-ray or CT were included in the study.

Exclusion criteria

  • Patients with metallic prosthesis which are not MRI compatible .
  • patients with previous Vertebral surgery.
  • patients with Vertebral Congenital anomalies
  • Patients refused the examination.
  • Patients who suffer from claustrophobia

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Study design

Observational model
Other

Study locations

Center list to be confirmed — check the primary protocol.

Publications

  • Leake RL, Mills MK, Hanrahan CJ. Spinal Marrow Imaging: Clues to Disease. Radiol Clin North Am. 2019 Mar;57(2):359-375. doi: 10.1016/j.rcl.2018.09.008. Epub 2018 Nov 17. PMID 30709475
  • Lin S, Ouyang T, Kanekar S. Imaging of Bone Marrow. Hematol Oncol Clin North Am. 2016 Aug;30(4):945-71. doi: 10.1016/j.hoc.2016.03.012. PMID 27444005
  • Dietrich O, Geith T, Reiser MF, Baur-Melnyk A. Diffusion imaging of the vertebral bone marrow. NMR Biomed. 2017 Mar;30(3). doi: 10.1002/nbm.3333. Epub 2015 Jun 26. PMID 26114411
  • Karampinos DC, Ruschke S, Dieckmeyer M, Diefenbach M, Franz D, Gersing AS, Krug R, Baum T. Quantitative MRI and spectroscopy of bone marrow. J Magn Reson Imaging. 2018 Feb;47(2):332-353. doi: 10.1002/jmri.25769. Epub 2017 Jun 1. PMID 28570033
  • Padhani AR, Koh DM. Diffusion MR imaging for monitoring of treatment response. Magn Reson Imaging Clin N Am. 2011 Feb;19(1):181-209. doi: 10.1016/j.mric.2010.10.004. PMID 21129641

Identifiers

NCT: NCT06703138 · MRI in bone marrow lesions

Primary sources (government registries)

View this study on ClinicalTrials.gov ↗