Download PDF
Semin Musculoskelet Radiol 2009; 13(2): 134-144
DOI: 10.1055/s-0029-1220884
© Thieme Medical Publishers

Diffusion-Weighted Imaging of Bone Marrow

Olaf Dietrich1 , Andreas Biffar1 , Maximilian F. Reiser2 , Andrea Baur-Melnyk2
  • 1Josef Lissner Laboratory for Biomedical Imaging, Department of Clinical Radiology, LMU Ludwig Maximilian University of Munich–Grosshadern Campus, Munich, Germany
  • 2Department of Clinical Radiology, LMU Ludwig Maximilian University of Munich–Grosshadern Campus, Munich, Germany
Further Information

Publication History

Publication Date:
19 May 2009 (online)

Also available at
    Permissions and Reprints

ABSTRACT

In diffusion-weighted magnetic resonance imaging (DWI-MRI), the observed MRI signal intensity is attenuated by the self-diffusion of water molecules. DWI can provide information about the microscopic structure and organization of biological tissue and thus can depict various pathological changes of organs or tissues. DWI has been successfully used for the characterization of bone marrow alterations or lesions, and in particular for the differentiation of benign and malignant vertebral compression fractures. In this review article, the basics of DWI are introduced, and several pulse sequences that have been used for DWI of the bone marrow are described. Subsequently, an extensive overview about diffusion studies of the bone marrow and in particular of DWI of vertebral compression fractures is provided.

KEYWORDS

Diffusion-weighted magnetic resonance imaging - bone marrow - vertebral compression fractures - pulse sequences

REFERENCES

  • 1 Karaarslan E, Arslan A. Diffusion weighted MR imaging in non-infarct lesions of the brain.  Eur J Radiol. 2008;  65(3) 402-416
    CrossrefPubMedGoogle Scholar
  • 2 Provenzale J M, Mukundan S, Barboriak D P. Diffusion-weighted and perfusion MR imaging for brain tumor characterization and assessment of treatment response.  Radiology. 2006;  239(3) 632-649
    CrossrefPubMedGoogle Scholar
  • 3 Cartes-Zumelzu F W, Stavrou I, Castillo M, Eisenhuber E, Knosp E, Thurnher M M. Diffusion-weighted imaging in the assessment of brain abscesses therapy.  AJNR Am J Neuroradiol. 2004;  25(8) 1310-1317
    PubMedGoogle Scholar
  • 4 Horsfield M A, Jones D K. Applications of diffusion-weighted and diffusion tensor MRI to white matter diseases—a review.  NMR Biomed. 2002;  15(7-8) 570-577
    CrossrefPubMedGoogle Scholar
  • 5 Schaefer P W, Copen W A, Lev M H, Gonzalez R G. Diffusion-weighted imaging in acute stroke.  Magn Reson Imaging Clin N Am. 2006;  14(2) 141-168
    CrossrefPubMedGoogle Scholar
  • 6 Davis D P, Robertson T, Imbesi S G. Diffusion-weighted magnetic resonance imaging versus computed tomography in the diagnosis of acute ischemic stroke.  J Emerg Med. 2006;  31(3) 269-277
    CrossrefPubMedGoogle Scholar
  • 7 Parikh T, Drew S J, Lee V S et al.. Focal liver lesion detection and characterization with diffusion-weighted MR imaging: comparison with standard breath-hold T2-weighted imaging.  Radiology. 2008;  246(3) 812-822
    CrossrefPubMedGoogle Scholar
  • 8 Zech C J, Herrmann K A, Dietrich O, Horger W, Reiser M F, Schoenberg S O. Black-blood diffusion-weighted EPI acquisition of the liver with parallel imaging: comparison with a standard T2-weighted sequence for detection of focal liver lesions.  Invest Radiol. 2008;  43(4) 261-266
    CrossrefPubMedGoogle Scholar
  • 9 Zhang J, Tehrani Y M, Wang L, Ishill N M, Schwartz L H, Hricak H. Renal masses: characterization with diffusion-weighted MR imaging—a preliminary experience.  Radiology. 2008;  247(2) 458-464
    CrossrefPubMedGoogle Scholar
  • 10 Cova M, Squillaci E, Stacul F et al.. Diffusion-weighted MRI in the evaluation of renal lesions: preliminary results.  Br J Radiol. 2004;  77(922) 851-857
    PubMedGoogle Scholar
  • 11 Nagata S, Nishimura H, Uchida M et al.. Diffusion-weighted imaging of soft tissue tumors: usefulness of the apparent diffusion coefficient for differential diagnosis.  Radiat Med. 2008;  26(5) 287-295
    CrossrefPubMedGoogle Scholar
  • 12 Dietrich O, Raya J G, Sommer J, Deimling M, Reiser M F, Baur-Melnyk A. A comparative evaluation of a RARE-based single-shot pulse sequence for diffusion-weighted MRI of musculoskeletal soft-tissue tumors.  Eur Radiol. 2005;  15(4) 772-783
    CrossrefPubMedGoogle Scholar
  • 13 Takahara T, Imai Y, Yamashita T, Yasuda S, Nasu S, Van Cauteren M. Diffusion weighted whole body imaging with background body signal suppression (DWIBS): technical improvement using free breathing, STIR and high resolution 3D display.  Radiat Med. 2004;  22(4) 275-282
    PubMedGoogle Scholar
  • 14 Kwee T C, Takahara T, Ochiai R, Nievelstein R A, Luijten P R. Diffusion-weighted whole-body imaging with background body signal suppression (DWIBS): features and potential applications in oncology.  Eur Radiol. 2008;  18(9) 1937-1952
    CrossrefPubMedGoogle Scholar
  • 15 Raya J G, Dietrich O, Reiser M F, Baur-Melnyk A. Methods and applications of diffusion imaging of vertebral bone marrow.  J Magn Reson Imaging. 2006;  24(6) 1207-1220
    CrossrefPubMedGoogle Scholar
  • 16 Baur A, Stäbler A, Brüning R et al.. Diffusion-weighted MR imaging of bone marrow: differentiation of benign versus pathologic compression fractures.  Radiology. 1998;  207(2) 349-356
    CrossrefPubMedGoogle Scholar
  • 17 Karchevsky M, Babb J S, Schweitzer M E. Can diffusion-weighted imaging be used to differentiate benign from pathologic fractures? A meta-analysis.  Skeletal Radiol. 2008;  37(9) 791-795
    CrossrefPubMedGoogle Scholar
  • 18 Raya J G, Dietrich O, Reiser M F, Baur-Melnyk A. Techniques for diffusion-weighted imaging of bone marrow.  Eur J Radiol. 2005;  55(1) 64-73
    CrossrefPubMedGoogle Scholar
  • 19 Hahn E L. Spin echoes.  Phys Rev. 1950;  80 580-594
    PubMedGoogle Scholar
  • 20 Stejskal E O, Tanner J E. Spin diffusion measurements: spin echoes in the presence of a time-dependent field gradient.  J Chem Phys. 1965;  42 288-292
    CrossrefPubMedGoogle Scholar
  • 21 Xing D, Papadakis N G, Huang C L, Lee V M, Carpenter T A, Hall L D. Optimised diffusion-weighting for measurement of apparent diffusion coefficient (ADC) in human brain.  Magn Reson Imaging. 1997;  15(7) 771-784
    CrossrefPubMedGoogle Scholar
  • 22 Trouard T P, Sabharwal Y, Altbach M I, Gmitro A F. Analysis and comparison of motion-correction techniques in diffusion-weighted imaging.  J Magn Reson Imaging. 1996;  6(6) 925-935
    CrossrefPubMedGoogle Scholar
  • 23 Norris D G. Implications of bulk motion for diffusion-weighted imaging experiments: effects, mechanisms, and solutions.  J Magn Reson Imaging. 2001;  13(4) 486-495
    CrossrefPubMedGoogle Scholar
  • 24 Basser P J, Mattiello J, LeBihan D. MR diffusion tensor spectroscopy and imaging.  Biophys J. 1994;  66(1) 259-267
    CrossrefPubMedGoogle Scholar
  • 25 Basser P J, Pierpaoli C. Microstructural and physiological features of tissues elucidated by quantitative-diffusion-tensor MRI.  J Magn Reson B. 1996;  111(3) 209-219
    CrossrefPubMedGoogle Scholar
  • 26 Basser P J, Pierpaoli C. A simplified method to measure the diffusion tensor from seven MR images.  Magn Reson Med. 1998;  39(6) 928-934
    CrossrefPubMedGoogle Scholar
  • 27 Merboldt K D, Hänicke W, Frahm J. Self-diffusion NMR imaging using stimulated echoes.  J Magn Reson. 1985;  64 479-486
    PubMedGoogle Scholar
  • 28 Taylor D G, Bushell M C. The spatial mapping of translational diffusion coefficients by the NMR imaging technique.  Phys Med Biol. 1985;  30(4) 345-349
    CrossrefPubMedGoogle Scholar
  • 29 Le Bihan D, Breton E, Lallemand D, Grenier P, Cabanis E, Laval-Jeantet M. MR imaging of intravoxel incoherent motions: application to diffusion and perfusion in neurologic disorders.  Radiology. 1986;  161(2) 401-407
    CrossrefPubMedGoogle Scholar
  • 30 Ordidge R J, Helpern J A, Qing Z X, Knight R A, Nagesh V. Correction of motional artifacts in diffusion-weighted MR images using navigator echoes.  Magn Reson Imaging. 1994;  12(3) 455-460
    CrossrefPubMedGoogle Scholar
  • 31 Anderson A W, Gore J C. Analysis and correction of motion artifacts in diffusion weighted imaging.  Magn Reson Med. 1994;  32(3) 379-387
    PubMedGoogle Scholar
  • 32 Dietrich O, Heiland S, Benner T, Sartor K. Reducing motion artefacts in diffusion-weighted MRI of the brain: efficacy of navigator echo correction and pulse triggering.  Neuroradiology. 2000;  42(2) 85-91
    CrossrefPubMedGoogle Scholar
  • 33 Gmitro A F, Alexander A L. Use of a projection reconstruction method to decrease motion sensitivity in diffusion-weighted MRI.  Magn Reson Med. 1993;  29(6) 835-838
    CrossrefPubMedGoogle Scholar
  • 34 Dietrich O, Herlihy A, Dannels W R et al.. Diffusion-weighted imaging of the spine using radial k-space trajectories.  MAGMA. 2001;  12 23-31
    PubMedGoogle Scholar
  • 35 Gudbjartsson H, Maier S E, Mulkern R V, Mórocz I A, Patz S, Jolesz F A. Line scan diffusion imaging.  Magn Reson Med. 1996;  36(4) 509-519
    CrossrefPubMedGoogle Scholar
  • 36 Turner R, Le Bihan D, Maier J, Vavrek R, Hedges L K, Pekar J. Echo-planar imaging of intravoxel incoherent motion.  Radiology. 1990;  177(2) 407-414
    PubMedGoogle Scholar
  • 37 Jaermann T, Pruessmann K P, Valavanis A, Kollias S, Boesiger P. Influence of SENSE on image properties in high-resolution single-shot echo-planar DTI.  Magn Reson Med. 2006;  55(2) 335-342
    CrossrefPubMedGoogle Scholar
  • 38 Norris D G, Börnert P, Reese T, Leibfritz D. On the application of ultra-fast RARE experiments.  Magn Reson Med. 1992;  27(1) 142-164
    CrossrefPubMedGoogle Scholar
  • 39 Schick F. SPLICE: sub-second diffusion-sensitive MR imaging using a modified fast spin-echo acquisition mode.  Magn Reson Med. 1997;  38(4) 638-644
    CrossrefPubMedGoogle Scholar
  • 40 Alsop D C. Phase insensitive preparation of single-shot RARE: application to diffusion imaging in humans.  Magn Reson Med. 1997;  38(4) 527-533
    CrossrefPubMedGoogle Scholar
  • 41 Pipe J G, Farthing V G, Forbes K P. Multishot diffusion-weighted FSE using PROPELLER MRI.  Magn Reson Med. 2002;  47(1) 42-52 , (Erratum in: Magn Reson Med 2002;47:621)
    CrossrefPubMedGoogle Scholar
  • 42 Gyngell M L. The application of steady-state free precession in rapid 2DFT NMR imaging: FAST and CE-FAST sequences.  Magn Reson Imaging. 1988;  6(4) 415-419
    CrossrefPubMedGoogle Scholar
  • 43 Bruder H, Fischer H, Graumann R, Deimling M. A new steady-state imaging sequence for simultaneous acquisition of two MR images with clearly different contrasts.  Magn Reson Med. 1988;  7(1) 35-42
    CrossrefPubMedGoogle Scholar
  • 44 Le Bihan D. Intravoxel incoherent motion imaging using steady-state free precession.  Magn Reson Med. 1988;  7(3) 346-351
    CrossrefPubMedGoogle Scholar
  • 45 Merboldt K D, Bruhn H, Frahm J, Gyngell M L, Hänicke W, Deimling M. MRI of “diffusion” in the human brain: new results using a modified CE-FAST sequence.  Magn Reson Med. 1989;  9(3) 423-429
    CrossrefPubMedGoogle Scholar
  • 46 Kaiser R, Bartholdi E, Ernst R R. Diffusion and field-gradient effects in NMR Fourier spectroscopy.  J Chem Phys. 1974;  60 2966-2979
    CrossrefPubMedGoogle Scholar
  • 47 Wu E X, Buxton R B. Effect of diffusion on the steady-state magnetization with pulsed field gradients.  J Magn Reson. 1990;  90 243-253
    PubMedGoogle Scholar
  • 48 Miller K L, Hargreaves B A, Gold G E, Pauly J M. Steady-state diffusion-weighted imaging of in vivo knee cartilage.  Magn Reson Med. 2004;  51(2) 394-398
    CrossrefPubMedGoogle Scholar
  • 49 Castillo M, Arbelaez A, Smith J K, Fisher L L. Diffusion-weighted MR imaging offers no advantage over routine noncontrast MR imaging in the detection of vertebral metastases.  AJNR Am J Neuroradiol. 2000;  21(5) 948-953
    PubMedGoogle Scholar
  • 50 Hackländer T, Scharwächter C, Golz R, Mertens H. Value of diffusion-weighted imaging for diagnosing vertebral metastases due to prostate cancer in comparison to other primary tumors.  Rofo. 2006;  178 416-424
    Article in Thieme ConnectPubMedGoogle Scholar
  • 51 Byun W M, Jang H W, Kim S W, Jang S H, Ahn S H, Ahn M W. Diffusion-weighted magnetic resonance imaging of sacral insufficiency fractures: comparison with metastases of the sacrum.  Spine. 2007;  32(26) E820-E824
    CrossrefPubMedGoogle Scholar
  • 52 Park S W, Lee J H, Ehara S et al.. Single shot fast spin echo diffusion-weighted MR imaging of the spine: is it useful in differentiating malignant metastatic tumor infiltration from benign fracture edema?.  Clin Imaging. 2004;  28(2) 102-108
    CrossrefPubMedGoogle Scholar
  • 53 Abanoz R, Hakyemez B, Parlak M. Diffusion-weighted imaging of acute vertebral compression: differential diagnosis of benign versus malignant pathologic fractures.  Tani Girisim Radyol. 2003;  9(2) 176-183
    PubMedGoogle Scholar
  • 54 Baur A, Huber A, Dürr H R et al.. Differentiation of benign osteoporotic and neoplastic vertebral compression fractures with a diffusion-weighted, steady-state free precession sequence.  Rofo. 2002;  174 70-75
    PubMedGoogle Scholar
  • 55 Byun W M, Shin S O, Chang Y, Lee S J, Finsterbusch J, Frahm J. Diffusion-weighted MR imaging of metastatic disease of the spine: assessment of response to therapy.  AJNR Am J Neuroradiol. 2002;  23(6) 906-912
    PubMedGoogle Scholar
  • 56 Yasumoto M, Nonomura Y, Yoshimura R et al.. MR detection of iliac bone marrow involvement by malignant lymphoma with various MR sequences including diffusion-weighted echo-planar imaging.  Skeletal Radiol. 2002;  31(5) 263-269
    CrossrefPubMedGoogle Scholar
  • 57 Spuentrup E, Buecker A, Adam G, van Vaals J J, Guenther R W. Diffusion-weighted MR imaging for differentiation of benign fracture edema and tumor infiltration of the vertebral body.  AJR Am J Roentgenol. 2001;  176(2) 351-358
    CrossrefPubMedGoogle Scholar
  • 58 Baur A, Huber A, Ertl-Wagner B et al.. Diagnostic value of increased diffusion weighting of a steady-state free precession sequence for differentiating acute benign osteoporotic fractures from pathologic vertebral compression fractures.  AJNR Am J Neuroradiol. 2001;  22(2) 366-372
    PubMedGoogle Scholar
  • 59 Yeung D K, Wong S Y, Griffith J F, Lau E M. Bone marrow diffusion in osteoporosis: evaluation with quantitative MR diffusion imaging.  J Magn Reson Imaging. 2004;  19(2) 222-228
    CrossrefPubMedGoogle Scholar
  • 60 Balliu E, Vilanova J C, Peláez I et al.. Diagnostic value of apparent diffusion coefficients to differentiate benign from malignant vertebral bone marrow lesions.  Eur J Radiol. 2008;  , February 12 (Epub ahead of print)
    PubMedGoogle Scholar
  • 61 Gašperšič N, Sersa I, Jevtic V, Tomsic M, Praprotnik S. Monitoring ankylosing spondylitis therapy by dynamic contrast-enhanced and diffusion-weighted magnetic resonance imaging.  Skeletal Radiol. 2008;  37(2) 123-131
    CrossrefPubMedGoogle Scholar
  • 62 Sugimoto T, Tanigawa N, Ikeda K et al.. Diffusion-weighted imaging for predicting new compression fractures following percutaneous vertebroplasty.  Acta Radiol. 2008;  49(4) 419-426
    CrossrefPubMedGoogle Scholar
  • 63 Tang G, Liu Y, Li W, Yao J, Li B, Li P. Optimization of b value in diffusion-weighted MRI for the differential diagnosis of benign and malignant vertebral fractures.  Skeletal Radiol. 2007;  36(11) 1035-1041
    CrossrefPubMedGoogle Scholar
  • 64 Hatipoglu H G, Selvi A, Ciliz D, Yuksel E. Quantitative and diffusion MR imaging as a new method to assess osteoporosis.  AJNR Am J Neuroradiol. 2007;  28(10) 1934-1937
    CrossrefPubMedGoogle Scholar
  • 65 Raya J G, Dietrich O, Birkenmaier C, Sommer J, Reiser M F, Baur-Melnyk A. Feasibility of a RARE-based sequence for quantitative diffusion-weighted MRI of the spine.  Eur Radiol. 2007;  17(11) 2872-2879
    CrossrefPubMedGoogle Scholar
  • 66 Oner A Y, Tali T, Celikyay F, Celik A, Le Roux P. Diffusion-weighted imaging of the spine with a non-Carr-Purcell-Meiboom-Gill single-shot fast spin-echo sequence: initial experience.  AJNR Am J Neuroradiol. 2007;  28(3) 575-580
    PubMedGoogle Scholar
  • 67 Griffith J F, Yeung D K, Antonio G E et al.. Vertebral marrow fat content and diffusion and perfusion indexes in women with varying bone density: MR evaluation.  Radiology. 2006;  241(3) 831-838
    CrossrefPubMedGoogle Scholar
  • 68 Pui M H, Mitha A, Rae W I, Corr P. Diffusion-weighted magnetic resonance imaging of spinal infection and malignancy.  J Neuroimaging. 2005;  15(2) 164-170
    CrossrefPubMedGoogle Scholar
  • 69 Ballon D, Watts R, Dyke J P et al.. Imaging therapeutic response in human bone marrow using rapid whole-body MRI.  Magn Reson Med. 2004;  52(6) 1234-1238
    CrossrefPubMedGoogle Scholar
  • 70 Maeda M, Sakuma H, Maier S E, Takeda K. Quantitative assessment of diffusion abnormalities in benign and malignant vertebral compression fractures by line scan diffusion-weighted imaging.  AJR Am J Roentgenol. 2003;  181(5) 1203-1209
    CrossrefPubMedGoogle Scholar
  • 71 Bammer R, Herneth A M, Maier S E et al.. Line scan diffusion imaging of the spine.  AJNR Am J Neuroradiol. 2003;  24(1) 5-12
    PubMedGoogle Scholar
  • 72 Herneth A M, Philipp M O, Naude J et al.. Vertebral metastases: assessment with apparent diffusion coefficient.  Radiology. 2002;  225(3) 889-894
    CrossrefPubMedGoogle Scholar
  • 73 Chan J H, Peh W C, Tsui E Y et al.. Acute vertebral body compression fractures: discrimination between benign and malignant causes using apparent diffusion coefficients.  Br J Radiol. 2002;  75(891) 207-214
    CrossrefPubMedGoogle Scholar
  • 74 Zhou X J, Leeds N E, McKinnon G C, Kumar A J. Characterization of benign and metastatic vertebral compression fractures with quantitative diffusion MR imaging.  AJNR Am J Neuroradiol. 2002;  23(1) 165-170
    PubMedGoogle Scholar
  • 75 Herneth A M, Naude J, Philipp M, Beichel R, Trattnig S, Imhof H. The value of diffusion-weighted MRT in assessing the bone marrow changes in vertebral metastases.  Radiologe. 2000;  40(8) 731-736
    CrossrefPubMedGoogle Scholar
  • 76 Le Bihan D, Breton E, Lallemand D, Aubin M L, Vignaud J, Laval-Jeantet M. Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging.  Radiology. 1988;  168(2) 497-505
    PubMedGoogle Scholar
  • 77 Moon W J, Lee M H, Chung E C. Diffusion-weighted imaging with sensitivity encoding (SENSE) for detecting cranial bone marrow metastases: comparison with T1-weighted images.  Korean J Radiol. 2007;  8(3) 185-191
    CrossrefPubMedGoogle Scholar
  • 78 Ragin A B, Wu Y, Storey P et al.. Bone marrow diffusion measures correlate with dementia severity in HIV patients.  AJNR Am J Neuroradiol. 2006;  27(3) 589-592
    PubMedGoogle Scholar
  • 79 Nonomura Y, Yasumoto M, Yoshimura R et al.. Relationship between bone marrow cellularity and apparent diffusion coefficient.  J Magn Reson Imaging. 2001;  13(5) 757-760
    CrossrefPubMedGoogle Scholar
  • 80 Ballon D, Dyke J, Schwartz L H et al.. Bone marrow segmentation in leukemia using diffusion and T (2) weighted echo planar magnetic resonance imaging.  NMR Biomed. 2000;  13(6) 321-328
    CrossrefPubMedGoogle Scholar
  • 81 Ward R, Caruthers S, Yablon C, Blake M, DiMasi M, Eustace S. Analysis of diffusion changes in posttraumatic bone marrow using navigator-corrected diffusion gradients.  AJR Am J Roentgenol. 2000;  174(3) 731-734
    PubMedGoogle Scholar
  • 82 Mürtz P, Krautmacher C, Träber F, Gieseke J, Schild H H, Willinek W A. Diffusion-weighted whole-body MR imaging with background body signal suppression: a feasibility study at 3.0 Tesla.  Eur Radiol. 2007;  17(12) 3031-3037
    CrossrefPubMedGoogle Scholar
  • 83 Koh D M, Takahara T, Imai Y, Collins D J. Practical aspects of assessing tumors using clinical diffusion-weighted imaging in the body.  Magn Reson Med Sci. 2007;  6(4) 211-224
    CrossrefPubMedGoogle Scholar

Olaf DietrichPh.D. 

Josef Lissner Laboratory for Biomedical Imaging, Department of Clinical Radiology

LMU Ludwig Maximilian University of Munich–Grosshadern Campus, Marchioninistr. 15, 81377 Munich, Germany

Email: od@dtrx.net

      >