title: Differentiation of focal indeterminate marrow abnormalities with multiparametric MRI.
abstract: To explore magnetic resonance imaging (MRI) parameters from intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI), multiecho Dixon imaging (ME-Dixon), and dynamic contrast-enhanced imaging (DCE) for differentiating focal indeterminate marrow abnormalities MATERIALS AND METHODS: Forty-two patients with 14 benign and 28 malignant focal marrow abnormalities were included. The following were independently analyzed by two readers: signal intensity (SI), contour, and margin on conventional MR images; SI on b-800 images (SIb-800), apparent diffusion coefficient (ADC), IVIM parameters (Dslow,Dfast, and f), fat fraction (Ff), and DCE parameters (time-to-signal intensity curve pattern, iAUC, Ktrans, kep, and ve). The MR characteristics and parameters from benign and malignant lesions were compared with a chi-squared test and the Mann-Whitney U-test, respectively. The area under receiver operating characteristic (ROC) curves (AUC) of each sequence were also compared. Interobserver agreements were assessed with Cohen's κ, and intraclass correlation coefficient (ICC).
  
  
  
  ADC, Dslow, and Ff demonstrated a significant difference between benign and malignant marrow abnormalities for both readers (P < 0.001). SIb-800and perfusion-related parameters from IVIM-DWI and DCE were not significantly different between the two groups (P = 0.145, 0.439, and 0.337 for reader 1, P = 0.378, 0.368, and 0.343 for reader 2, respectively). The AUCs of ADC, Dslow, and Ff were significantly higher for differentiating indeterminate marrow abnormalities in both readers (P < 0.001). Interobserver agreements were substantial in SIb-800, and ICCs were almost perfect for ADC, Dslow, f, and Ff, and substantial for iAUC, kep, Ktrans, ve, and Dfast.
  
  
  
  ADC, Dslow, and Ff may provide information for differentiating focal indeterminate abnormalities.
  
  
  
  3 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;46:49-60.
authors.affiliation: Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea.
authors.forename: Jun Seung
authors.initials: JS
authors.lastname: Baik
authors.affiliation: Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea.
authors.forename: Joon-Yong
authors.initials: JY
authors.lastname: Jung
authors.affiliation: Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea.
authors.forename: Won-Hee
authors.initials: WH
authors.lastname: Jee
authors.affiliation: Department of Radiology, Uijeongbu St. Mary's Hospital.
authors.forename: Chang-Woo
authors.initials: CW
authors.lastname: Chun
authors.affiliation: Incheon St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea.
authors.forename: Sun Ki
authors.initials: SK
authors.lastname: Kim
authors.affiliation: Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea.
authors.forename: Seung Han
authors.initials: SH
authors.lastname: Shin
authors.affiliation: Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea.
authors.forename: Yang Guk
authors.initials: YG
authors.lastname: Chung
authors.affiliation: Department of Pathology, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea.
authors.forename: Chan-Kwon
authors.initials: CK
authors.lastname: Jung
authors.affiliation: Siemens Healthcare, Erlangen, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Kannengiesser
authors.affiliation: Siemens Healthcare, Seoul, Republic of Korea.
authors.forename: YoHan
authors.initials: Y
authors.lastname: Sohn
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019046:Bone Marrow Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D015588:Observer Variation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: bone marrow; chemical shift; dynamic contrast-enhanced imaging; intravoxel incoherent motion