Quantitative assessment of the mandibular bone marrow of diabetes mellitus patients using diffusion-weighted magnetic resonance imaging

Purpose: The purpose of this study was to assess quantitatively the mandibular bone marrow of patients with and without diabetes mellitus (DM) using the apparent diffusion coefficient (ADC) values on diffusion-weighted imaging (DWI). Methods: 65 DM patients (28 men, 37 women, 29–84 years of age, mean age 55.7 ± 15.7 years) and age-, sex- and periodontitis stage-matched 65 non-DM patients who had underwent MRI between April 2006 and March 2018 were included in this study. The ADC was calculated using the ADC visualization tool implemented in a dedicated off-line workstation. The regions of interest (ROI) were manually placed on the ADC map on which the mandibular bone marrow from the lower first molar to the lower second molar was observed in patients with and without DM. Statistical analysis was performed using the Mann–Whitney U test and receiver operating characteristic (ROC) curve analysis. P values < 0.05 were considered statistically significant. Results: The mean ADC values of the mandibular bone marrow of patients with and without DM were 1.18 ± 0.21 × 10⁻³ mm²/s and 0.83 ± 0.14 × 10⁻³ mm²/s, respectively. The ADC values of DM patients were significantly higher than those of patients without DM. Conclusion: The ADC values allowed the quantitative evaluation of the mandibular bone marrow of DM patients. DWI might serve as a new and noninvasive method to assess the presence of DM.