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

PURPOSE:To investigate the value of intravoxel incoherent motion (IVIM) parameters in evaluation of prognosis in patients with acute myeloid leukemia (AML) before treatment. MATERIALS AND METHODS: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. RESULTS: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. CONCLUSION: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. LEVEL OF EVIDENCE:1 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;46:476-482.