Efficacy of chemical shift MRI for differentiating diffuse red bone marrow reconversion and hematological malignancies

Background/aim: The main purpose of our study was to determine the efficacy of chemical shift imaging (CSI) for differentiating diffuse red bone marrow reconversion (RBMR) and hematological malignancies. We also aimed to calculate the cut-off value for these entities with similar imaging features in routine magnetic resonance (MR) sequences. Materials and methods: A total of 54 patients were included: 17 patients (31.4%) with hematological malignancies (group 1), 16 patients (29.6%) with RBMR (group 2), and 21 patients (38.0%) with no clinical and hematological malignancies (control group). Patients with no pathological data or completed two-year follow-up and children were excluded from the study. An experienced radiologist on MRI evaluated the images blindly for final diagnosis. Pathologic results were determined as gold standard. Regions of interests (ROI) were placed on the vertebrae in CSI and signal intensity ratios (SIR) were calculated. The cut-off value was calculated using receiver operating characteristic (ROC) analysis. Results: SIR values were 0.97 ± 0.16, 0.69 ± 0.31 and 0.28 ± 0.35 (P < 0.001) for GI, G2, and G3, respectively. The cut-off value was 0.82 (P < 0.001). The sensitivity rate was 83.3% (AUC: 58%–96%), specificity was 87% (AUC: 58–98). Conclusion: CSI may be a valuable diagnostic tool for differentiating diffuse RBMR and hematological malignancies.