RESULTS
A total of 171 bone lesions were demonstrated by MR on 18 patients between 2 months and 9.2 years of age (mean age: 4 years and 2 months) with a male/female ratio of 3/1.
On MIBG, a total of 73 bone lesions were reported as positive. 9 MIBG positive bone lesions did not have representation on MR.
Based on the topography of each bone lesion, coincidence between MR and MIBG was observed in 62 lesions. Mean ADC values of positive MIBG bone lesions was 0.625 x 10-3 mm2/sec, SD 0.065. MR demonstrated 123 bone lesions that were MIBG negative with a mean ADC value of 1.43 x 10-3 mm2/sec, SD 0.066 (p<0.005). Also relevant, we demonstrated 9 bone lesions on MR with ADC values <1 x10-3mm2/sec and negative on MIBG.
A statistically significant correlation was established between MIBG positive bone lesions and a lower ADC value on DWI.
Fig. 1
Fig. 1: Negative MIBG and Negative DWIBS
Fig. 2
Fig. 2: Positive MIBG (multiple Bone lesions) and its correlation with positive DWIBS. Note the limitation on the evaluation of skull bone involvement on DWIBS compared to MIBG.
Fig. 3
Fig. 3: Negative MIBG, positive on DWIBS but high ADC value, considered as a residual bone lesion.
Fig. 4
Fig. 4: Negative MIBG. Bilateral femur hyperintense STIR bone lesions with high values on ADC map (1.92 10-3mm2/seg and 2.02 10-3mm2/seg).
Fig. 5
Fig. 5: Correlation between positive MIBG and DWIBS with ADC calculation on the proximal right femur lesion (0.76 x10-3mm2/seg).
Fig. 6
Fig. 6: Correlation between MIBG SPECT and DWI in a patient with a positive bone lesion in the left scapula (ADC 0.61 x10-3mm2/seg)
Fig. 7
Fig. 7: Correlation between MIBG SPECT and DWI in a patient with multiple bone lesions on both studies. ADC evaluation of the left proximal femur lesion (ADC 0.53 x10-3mm2/seg).
Fig. 8
Fig. 8: Correlation between MIBG SPECT and DWI in a patient with multiple bone lesions on both studies. ADC evaluation of the right proximal femur lesion (ADC 0.40 x10-3mm2/seg).
Fig. 9
Fig. 9: Correlation between MIBG SPECT and DWI in a patient with multiple bone lesions on both studies. ADC evaluation of the left tibiae lesion (ADC 0.63 x10-3mm2/seg).
Fig. 10
Fig. 10: Correlation between MIBG and DWI in a patient with soft tissue lesions in the upper left hemithorax and pelvis (arrows) and a bone lesion in the left tibia. ADC evaluation of the bone lesion (ADC 0.45 x10-3mm2/seg).