title: Role of diffusion-weighted imaging for detecting bone marrow infiltration in skull in children with acute lymphoblastic leukemia.
abstract: OBJECTIVE
  We aimed to determine whether diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) measurement can detect skull bone marrow infiltration in newly diagnosed acute lymphoblastic leukemia (ALL) children before therapy and normalization in complete remission after treatment.
  
  
  METHODS
  Fifty-one newly diagnosed acute lymphoblastic leukemia (ALL) patients and 30 healthy age-matched subjects were included. Cranial magnetic resonance imaging (MRI) scans were reviewed, and skull marrow ADC values were compared before treatment and in complete remission after therapy.
  
  
  RESULTS
  Skull marrow infiltration, manifested with abnormal DWI signals, was present in 37 patients (72.5%) before treatment. Of these, 23 (62.2%) showed scattered signal abnormalities and 14 (37.8%) showed a uniform abnormal signal pattern. Compared with the control group, ADC was significantly decreased in patients with ALL. DWI signal intensity and ADC normalized in patients with complete remission.
  
  
  CONCLUSIONS
  DWI is a useful and noninvasive tool for detecting skull infiltration in ALL children before treatment and normalization at complete remission after therapy, and it is superior to conventional MRI in terms of conspicuity of these lesions. DWI could be used as an MRI biomarker for evaluation of treatment in ALL children.
authors.affiliation: Graduate College, Southern Medical University, Guangdong General Hospital, Guangzhou, China; Department of Radiology, Shenzhen Children's Hospital, Shenzhen, China. cjr.lchh@vip.163.com.
authors.forename: Weiguo
authors.initials: W
authors.lastname: Cao
authors.forename: Changhong
authors.initials: C
authors.lastname: Liang
authors.forename: Yungan
authors.initials: Y
authors.lastname: Gen
authors.forename: Chen
authors.initials: C
authors.lastname: Wang
authors.forename: Cailei
authors.initials: C
authors.lastname: Zhao
authors.forename: Longwei
authors.initials: L
authors.lastname: Sun
mesh_terms: D001853:Bone Marrow / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000000981:diagnostic imaging / Q000628:therapy*; D012886:Skull / Q000000981:diagnostic imaging*; D016896:Treatment Outcome