Diffusion-Weighted MRI in Cranial Bone Marrow Metastasis
Abstract
Purpose: Diffusion-weighted MR imaging (DW-MRI) is generally applied to diagnose intra-axial brain pathologies such as parenchyma metastasis, abscesses, and infarcts in patients with systemic cancer. This study aimed to evaluate the DW-MRI findings in cranial bone marrow metastases to facilitate diagnosis. Material and Methods: Conventional MR imaging and DW-MRI findings of 57 patients with cranial bone marrow metastases were evaluated retrospectively. These images were evaluated by two neuroradiologists for lesion detection and lesion consciousness. Reader agreement was assessed by κ statistics. Results: Fifty-seven patients exhibited 113 cranial bone marrow metastases. The sensitivities of DW-MRI and the apparent diffusion coefficient to detect cranial bone metastasis for all types of primary malignancy were 86% and 90%, respectively. The sensitivities of T1-weighted imaging (T1WI), fluid attenuation inversion recovery, contrast-enhanced fat-suppressed (CE-FS) T1WI, and T2WI sequences to detect cranial bone metastasis were 93%, 90%, 89%, and 84%, respectively. Regarding lesion conspicuousness, DW-MRI was equivalent to CE-FS T1WI and equivalent or superior to non-contrast conventional sequences in most of the cranial bone marrow metastases. Interobserver agreement was excellent. Conclusions: DW-MRI is generally indicated not only to assess the diagnosis of parenchyma involvement, but also to discover the cranial bone marrow metastasis in patients with systemic cancer.
Keywords
Cranial bone marrow, metastases, brain MRI, diffusion-weighted MRI
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