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Diagnostic Accuracy of Quantitative Imaging Biomarkers in the Differentiation of Benign and Malignant Vertebral Lesions: Combination of Diffusion-Weighted and Proton Density Fat Fraction Spine MRI
PURPOSE: To compare and combine the diagnostic performance of the apparent diffusion coefficient (ADC) derived from diffusion-weighted imaging (DWI) and proton density fat fraction (PDFF) derived from chemical-shift encoding (CSE)-based water-fat magnetic resonance imaging (MRI) for distinguishing b...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8648653/ https://www.ncbi.nlm.nih.gov/pubmed/33787957 http://dx.doi.org/10.1007/s00062-021-01009-1 |
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author | Schmeel, Frederic Carsten Enkirch, Simon Jonas Luetkens, Julian Alexander Faron, Anton Lehnen, Nils Sprinkart, Alois Martin Schmeel, Leonard Christopher Radbruch, Alexander Attenberger, Ulrike Kukuk, Guido Matthias Mürtz, Petra |
author_facet | Schmeel, Frederic Carsten Enkirch, Simon Jonas Luetkens, Julian Alexander Faron, Anton Lehnen, Nils Sprinkart, Alois Martin Schmeel, Leonard Christopher Radbruch, Alexander Attenberger, Ulrike Kukuk, Guido Matthias Mürtz, Petra |
author_sort | Schmeel, Frederic Carsten |
collection | PubMed |
description | PURPOSE: To compare and combine the diagnostic performance of the apparent diffusion coefficient (ADC) derived from diffusion-weighted imaging (DWI) and proton density fat fraction (PDFF) derived from chemical-shift encoding (CSE)-based water-fat magnetic resonance imaging (MRI) for distinguishing benign and malignant vertebral bone marrow lesions (VBML). METHODS: A total of 55 consecutive patients with 53 benign (traumatic, inflammatory and primary) and 36 malignant (metastatic and hematologic) previously untreated VBMLs were prospectively enrolled in this IRB-approved study and underwent sagittal DWI (single-shot spin-echo echo-planar with multi-slice short TI inversion recovery fat suppression) and CSE-based MRI (gradient-echo 6‑point modified Dixon) in addition to routine clinical spine MRI at 1.5 T or 3.0 T. Diagnostic reference standard was established according to histopathology or imaging follow-up. The ADC = ADC (0, 800) and PDFF = fat / (water + fat) were calculated voxel-wise and examined for differences between benign and malignant lesions. RESULTS: The ADC and PDFF values of malignant lesions were significantly lower compared to benign lesions (mean ADC 861 × 10(−6) mm(2)/s vs. 1323 × 10(−6) mm(2)/s, p < 0.001; mean PDFF 3.1% vs. 28.2%, p < 0.001). The areas under the curve (AUC) and diagnostic accuracies were 0.847 (p < 0.001) and 85.4% (cut-off at 1084.4 × 10(−6) mm(2)/s) for ADC and 0.940 (p < 0.001) and 89.9% for PDFF (cut-off at 7.8%), respectively. The combined use of ADC and PDFF improved the diagnostic accuracy to 96.6% (malignancy if ADC ≤ 1118.2 × 10(−6) mm(2)/s and PDFF ≤ 20.0%, otherwise benign). CONCLUSION: Quantitative evaluation of both ADC and PDFF was useful in differentiating benign VBMLs from malignancy. The combination of ADC and PDFF improved the diagnostic performance and yielded high diagnostic accuracy for the differentiation of benign and malignant VBMLs. |
format | Online Article Text |
id | pubmed-8648653 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-86486532021-12-08 Diagnostic Accuracy of Quantitative Imaging Biomarkers in the Differentiation of Benign and Malignant Vertebral Lesions: Combination of Diffusion-Weighted and Proton Density Fat Fraction Spine MRI Schmeel, Frederic Carsten Enkirch, Simon Jonas Luetkens, Julian Alexander Faron, Anton Lehnen, Nils Sprinkart, Alois Martin Schmeel, Leonard Christopher Radbruch, Alexander Attenberger, Ulrike Kukuk, Guido Matthias Mürtz, Petra Clin Neuroradiol Original Article PURPOSE: To compare and combine the diagnostic performance of the apparent diffusion coefficient (ADC) derived from diffusion-weighted imaging (DWI) and proton density fat fraction (PDFF) derived from chemical-shift encoding (CSE)-based water-fat magnetic resonance imaging (MRI) for distinguishing benign and malignant vertebral bone marrow lesions (VBML). METHODS: A total of 55 consecutive patients with 53 benign (traumatic, inflammatory and primary) and 36 malignant (metastatic and hematologic) previously untreated VBMLs were prospectively enrolled in this IRB-approved study and underwent sagittal DWI (single-shot spin-echo echo-planar with multi-slice short TI inversion recovery fat suppression) and CSE-based MRI (gradient-echo 6‑point modified Dixon) in addition to routine clinical spine MRI at 1.5 T or 3.0 T. Diagnostic reference standard was established according to histopathology or imaging follow-up. The ADC = ADC (0, 800) and PDFF = fat / (water + fat) were calculated voxel-wise and examined for differences between benign and malignant lesions. RESULTS: The ADC and PDFF values of malignant lesions were significantly lower compared to benign lesions (mean ADC 861 × 10(−6) mm(2)/s vs. 1323 × 10(−6) mm(2)/s, p < 0.001; mean PDFF 3.1% vs. 28.2%, p < 0.001). The areas under the curve (AUC) and diagnostic accuracies were 0.847 (p < 0.001) and 85.4% (cut-off at 1084.4 × 10(−6) mm(2)/s) for ADC and 0.940 (p < 0.001) and 89.9% for PDFF (cut-off at 7.8%), respectively. The combined use of ADC and PDFF improved the diagnostic accuracy to 96.6% (malignancy if ADC ≤ 1118.2 × 10(−6) mm(2)/s and PDFF ≤ 20.0%, otherwise benign). CONCLUSION: Quantitative evaluation of both ADC and PDFF was useful in differentiating benign VBMLs from malignancy. The combination of ADC and PDFF improved the diagnostic performance and yielded high diagnostic accuracy for the differentiation of benign and malignant VBMLs. Springer Berlin Heidelberg 2021-03-31 2021 /pmc/articles/PMC8648653/ /pubmed/33787957 http://dx.doi.org/10.1007/s00062-021-01009-1 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Schmeel, Frederic Carsten Enkirch, Simon Jonas Luetkens, Julian Alexander Faron, Anton Lehnen, Nils Sprinkart, Alois Martin Schmeel, Leonard Christopher Radbruch, Alexander Attenberger, Ulrike Kukuk, Guido Matthias Mürtz, Petra Diagnostic Accuracy of Quantitative Imaging Biomarkers in the Differentiation of Benign and Malignant Vertebral Lesions: Combination of Diffusion-Weighted and Proton Density Fat Fraction Spine MRI |
title | Diagnostic Accuracy of Quantitative Imaging Biomarkers in the Differentiation of Benign and Malignant Vertebral Lesions: Combination of Diffusion-Weighted and Proton Density Fat Fraction Spine MRI |
title_full | Diagnostic Accuracy of Quantitative Imaging Biomarkers in the Differentiation of Benign and Malignant Vertebral Lesions: Combination of Diffusion-Weighted and Proton Density Fat Fraction Spine MRI |
title_fullStr | Diagnostic Accuracy of Quantitative Imaging Biomarkers in the Differentiation of Benign and Malignant Vertebral Lesions: Combination of Diffusion-Weighted and Proton Density Fat Fraction Spine MRI |
title_full_unstemmed | Diagnostic Accuracy of Quantitative Imaging Biomarkers in the Differentiation of Benign and Malignant Vertebral Lesions: Combination of Diffusion-Weighted and Proton Density Fat Fraction Spine MRI |
title_short | Diagnostic Accuracy of Quantitative Imaging Biomarkers in the Differentiation of Benign and Malignant Vertebral Lesions: Combination of Diffusion-Weighted and Proton Density Fat Fraction Spine MRI |
title_sort | diagnostic accuracy of quantitative imaging biomarkers in the differentiation of benign and malignant vertebral lesions: combination of diffusion-weighted and proton density fat fraction spine mri |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8648653/ https://www.ncbi.nlm.nih.gov/pubmed/33787957 http://dx.doi.org/10.1007/s00062-021-01009-1 |
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