{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T01:11:16Z","timestamp":1790730676323,"version":"4.1.0"},"reference-count":40,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,8,5]],"date-time":"2020-08-05T00:00:00Z","timestamp":1596585600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004923","name":"AFM-T\u00e9l\u00e9thon","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004923","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001677","name":"Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001677","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The monoexponential water T<jats:sub>2<\/jats:sub> (T<jats:sub>2\u2010mono<\/jats:sub>) is a proven biomarker of disease activity in neuromuscular disorders (NMDs). However, it lacks specificity, being elevated in the presence of several pathological processes and pathomorphological alterations in the muscle tissue.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To investigate the multiexponential behavior of the water T<jats:sub>2<\/jats:sub>\u2010relaxation in the skeletal muscle of NMD patients, aiming to identify more sensitive and specific biomarkers of disease activity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Type<\/jats:title><jats:p>Retrospective case\u2013control.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Thirty Duchenne muscular dystrophy and 114 inclusion body myositis patients and 55 control subjects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Field Strength\/Sequence<\/jats:title><jats:p>3T\/Single\u2010voxel proton spectroscopy (<jats:sup>1<\/jats:sup>H\u2010MRS) and multispin\u2010echo (MSE) imaging.<\/jats:p><\/jats:sec><jats:sec><jats:title>Assessment<\/jats:title><jats:p>Water T<jats:sub>2<\/jats:sub>\u2010decay curves generated from <jats:sup>1<\/jats:sup>H\u2010MRS data acquired at 14 echo\u2010times were fitted to mono\u2010 and biexponential models and the adjusted R<jats:sup>2<\/jats:sup> of each fit was computed. Additionally, T<jats:sub>2<\/jats:sub> spectra were generated from a regularized inverse Laplace transform. For comparison, water T<jats:sub>2<\/jats:sub> maps were generated from the MSE data. The performances of the different variables at identifying patients were assessed via receiver operating characteristic (ROC)\u2010curve analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Statistical Tests<\/jats:title><jats:p>Chi\u2010square, Kruskal\u2013Wallis, and Mann\u2013Whitney with Bonferroni correction for multiple comparisons.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>T<jats:sub>2\u2010mono<\/jats:sub> was elevated in patients (<jats:italic>P<\/jats:italic>&lt;0.05), but could not distinguish inclusion body myositis (IBM) from Duchenne muscular dystrophy (DMD). While 79% of IBM data presented a biexponential behavior, this was only 16% and 10% for DMD and control data, respectively (<jats:italic>P<\/jats:italic>&lt;0.05). All T<jats:sub>2<\/jats:sub> spectra presented an intermediate\u2010T<jats:sub>2<\/jats:sub> peak characterized by an elevated T<jats:sub>2<\/jats:sub> in patients (<jats:italic>P<\/jats:italic>&lt;0.05) and by a relative fraction that was abnormally smaller in IBM patients (<jats:italic>P<\/jats:italic>&lt;0.05). Also, a long\u2010T<jats:sub>2<\/jats:sub> peak was exclusively observed in IBM patients. A combination of T<jats:sub>2<\/jats:sub>\u2010spectrum variables performed best at identifying patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Conclusion<\/jats:title><jats:p>T<jats:sub>2<\/jats:sub> spectra not only provided more sensitive and specific markers of disease presence than the T<jats:sub>2\u2010mono<\/jats:sub>, but also allowed distinguishing IBM from DMD patients. This must reflect distinct predominant pathological alterations between these diseases, suggesting that these markers provide additional pathophysiological\/histopathological information that are missing from T<jats:sub>2\u2010mono<\/jats:sub>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>3<\/jats:p><\/jats:sec><jats:sec><jats:title>Technical Efficacy Stage<\/jats:title><jats:p>3<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmri.27300","type":"journal-article","created":{"date-parts":[[2020,8,6]],"date-time":"2020-08-06T06:29:53Z","timestamp":1596695393000},"page":"181-189","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Multiexponential Analysis of the Water <scp>T2<\/scp>\u2010Relaxation in the Skeletal Muscle Provides Distinct Markers of Disease Activity Between Inflammatory and Dystrophic Myopathies"],"prefix":"10.1002","volume":"53","author":[{"given":"Ericky C. 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