Validation of IVIM Perfusion and Diffusion Mapping to Detect Bone Marrow Ischemia: A Piglet Model Study

Motivation: Intravoxel incoherent motion (IVIM) imaging is a potential non-invasive alternative to contrast-enhanced MRI (CE-MRI) for assessing changes in bone marrow perfusion and diffusion. Goal(s): To assess the sensitivity of IVIM parameters, specifically the perfusion fraction and diffusion coefficient, to detect acute femoral head ischemia in a piglet model. Approach: 36 piglets underwent bilateral hip imaging using 3T MRI before and after surgically induced ischemia in one femoral head. IVIM metrics were analyzed across pre- and post-operative scans. Results: IVIM imaging was sensitive in detecting ischemia and subsequent injury to the femoral head, supporting its potential as a measure of bone marrow perfusion. Impact: IVIM imaging can detect bone marrow perfusion, ischemia, and injury, which is potentially clinically useful to evaluate ischemic bone disorders, including Legg-Calve-Perthes disease and other pediatric disorders for which there is a need for safer alternatives to gadolinium contrast-enhanced MRI.