Intravoxel incoherent motion diffusion-weighted imaging of bone marrow in patients with acute myeloid leukemia: a pilot study of prognostic value.

Abstract

To investigate the value of intravoxel incoherent motion (IVIM) parameters in evaluation of prognosis in patients with acute myeloid leukemia (AML) before treatment. Fifty-three patients before standard chemotherapy underwent MRI scans at 1.5 Tesla using conventional diffusion weighted imaging (DWI) and IVIM (b = 0, 10, 25, 50, 100, 200, 400, 600, 800, 1000, 1200 s/mm2 ) in the sagittal plane covering the lumbar bone marrow. The IVIM parameters (perfusion fraction [f], molecular diffusion coefficient [D], and perfusion-related D [D*] and apparent diffusion coefficient (ADC) were extracted from the bone marrow images. All patients were divided into complete remission (CR) and nonremission (NR) group according to the treatment response. All patients underwent the first remission induction chemotherapy, with 33 patients achieved CR and 20 patients achieved NR. The ADC values were not significant different between the two groups (P = 0.118). However, D value of CR group was significantly higher (P = 0.010), and f value of CR group was significantly lower (P = 0.021) than those of NR group. D* values had no significant differences between the two groups (P = 0.955). The D and f values were significant prognostic factors of AML after controlling for potential confounding factors (age, gender and smoking). Using receiver operator characteristic analysis, the area under the curve of D and f were 0.759 and 0.666, respectively, in evaluating prognosis of AML before treatment. There were significant differences in IVIM parameters between CR and NR patients of AML before treatment, and the D and f could play a potential role in prognosticating patients with AML. 1 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;46:476-482.