Quantitative evaluation of diffusion-weighted imaging with multiple b-values in vertebral fractures

Количественная оценка диффузионно-взвешенной визуализации с множественным b-значением при переломах позвонков
Fatma Kulali 1
More Detail
1 Radiology Department, University of Health Sciences, Umraniye Training and Research Hospital, Istanbul, Turkey
J CLIN MED KAZ, Volume 3, Issue 49, pp. 35-41. https://doi.org/10.23950/1812-2892-JCMK-00584
OPEN ACCESS 3197 Views 2300 Downloads
Download Full Text (PDF)

ABSTRACT

Aim: Differentiating benign from malignant vertebral fracture is sometimes difficult in geriatric oncology patients. Accurate diagnosis is necessary for treatment planning. Therefore, we aimed to investigate the role of quantitative evaluation of diffusion-weighted imaging (DWI) at multiple b-values of 200, 400 and 600 s/mm2 in differentiating benign from malignant thoracolumbar vertebral fractures and to determine an optimal b-value.
Methods: Forty-four patients with 72 vertebral fractures were enrolled. Magnetic resonance imaging (MRI) findings combined with DWI at b-values of 200, 400 and 600 s/mm2 were evaluated. Apparent diffusion coefficient (ADC) and normalized ADC values were obtained. Radiological and histopathological/follow-up results were compared.
Results: Of 72 vertebral fractures, 22 were benign and 50 were malignant. Mean ADC and normalized ADC values of malignant group were lower than benign group’s in all b-values (p<0.05). Despite of no significant difference between ADC values at b-values of 200, 400 and 600 s/mm2 within each group, normalized ADC values were lower at b-value of 200 s/mm2 than those of at 600 s/mm2 in malignant group (p<0.05).
Conclusion: MRI combined with DWI is a problem solving modality especially in geriatric oncology patients. Performing DWI at b-value of 200 s/mm2 and estimation of normalized ADC value for optimization of data are recommended.
Keywords: apparent diffusion coefficient, diffusion-weighted imaging, magnetic resonance imaging, vertebral fracture

CITATION

Kulali F. Quantitative evaluation of diffusion-weighted imaging with multiple b-values in vertebral fractures. Journal of Clinical Medicine of Kazakhstan. 2018;3(49):35-41. https://doi.org/10.23950/1812-2892-JCMK-00584

REFERENCES

  • Filograna L, Magarelli N, Cellini F, Manfrida S, Leone A, Colosimo C, et al. Diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC) values for detection of malignant vertebral bone marrow lesions. Eur Rev Med Pharmacol Sci. 2018; 22(3):590-597.
  • Takigawa T, Tanaka M, Sugimoto Y, Tetsunaga T, Nishida K, Ozaki T. Discrimination between malignant and benign vertebral fractures using magnetic resonance imaging. Asian Spine J. 2017; 11(3):478-483.
  • Padhani AR, van Ree K, Collins DJ, D’Sa S, Makris A. Assessing the relation between bone marrow signal intensity and apparent diffusion coefficient in diffusion-weighted MRI. AJR Am J Roentgenol. 2013; 200(1):163-70.
  • Torres C, Hammond I. Computed tomography and magnetic resonance imaging in the differentiation of osteoporotic fractures from neoplastic metastatic fractures. J ClinDensitom. 2016; 19(1):63-9.
  • Lee DH, Nam JK, Jung HS, Kim SJ, Chung MK, Park SW. Does T1- and diffusion-weighted magnetic resonance imaging give value-added than bone scintigraphy in the follow-up of vertebral metastasis of prostate cancer? InvestigClin Urol. 2017; 58(5):324-330.
  • Mauch JT, Carr CM, Cloft H, Diehn FE. Review of the imaging features of benign osteoporotic and malignant vertebral compression fractures. AJNR Am J Neuroradiol. 2018; 18. doi: 10.3174/ajnr.A5528.
  • Hamimi A, Kassab F, Kazkaz G. Osteoporotic or malignant vertebral fracture? This is the question. What can we do about it? Egypt J RadiolNucl Med.2015; 46: 97-103.
  • Koh DM, Collins DJ. Diffusion-weighted MRI in the body: applications and challenges in oncology. AJR Am J Roentgenol. 2007; 188(6):1622-35.
  • Dietrich O, Biffar A, Baur-Melnyk A, Reiser MF. Technical aspects of MR diffusion imaging of the body. Eur J Radiol. 2010; 76(3):314-22.
  • Dietrich O, Geith T, Reiser MF, Baur-Melnyk A. Diffusion imaging of the vertebral bone marrow. NMR Biomed. 2017; 30(3).
  • Matrawy KA, El-Nekeidy AA, El-Sheridy H. Atypical hemangioma and malignant lesions of spine: Can diffusion weighted magnetic resonance imaging help to differentiate? Egypt J Radiol Nucl Med. 2013; 44:259-263.
  • Caranci F, Tedeschi E, Ugga L, D’Amico A, Schipani S, Bartollino S, et al. Magnetic resonance imaging correlates of benign and malignant alterations of the spinal bone marrow. Acta Biomed. 2018; 19; 89(1-S):18-33.
  • Suh CH, Yun SJ, Jin W, Lee SH, Park SY, Ryu CW. ADC as a useful diagnostic tool for differentiating benign and malignant vertebral bone marrow lesions and compression fractures: a systematic review and meta-analysis. EurRadiol. 2018; 15. doi: 10.1007/s00330-018-5330-5.
  • Castillo M, Arbalaez A, Simith JK, Fisher LL. Diffusion-weighted MRI offers no advantage over routine noncontrast MR imaging in the detection of vertebral metastases. AJNR 2000; 21:948-953.
  • Bhugaloo A, Abdullah B, Siow Y, Ng Kh. Diffusion weighted MR imaging in acute vertebral compression fractures: differentiation between malignant and benign causes. Biomed Imaging Interv J. 2006; 2(2):e12.doi: 10.2349/biij.2.2.e12.
  • Pozzi G, Garcia Parra C, Stradiotti P, Tien TV, Luzzati A, Zerbi A.Diffusion-weighted MR imaging in differentiation between osteoporotic and neoplastic vertebral fractures. Eur Spine J. 2012; 21 Suppl 1:S123-7.
  • Abowarda MH, Abdel-Rahman HM, Taha MM. Differentiation of acute osteoporotic from malignant vertebral compression fractures with conventional MRI and diffusion MR imaging. Egypt J RadiolNucl Med.2016; 48:207-213.
  • Pozzi G, Albano D, Messina C, Angileri SA, Al-Mnayyis A, Galbusera F, et al. Solid bone tumors of the spine: Diagnostic performance of apparent diffusion coefficient measured using diffusion-weighted MRI using histology as a reference standard. J MagnReson Imaging. 2018; 47(4):1034-1042.
  • Fawzy F, Tantawy HI, Ragheb A, Hashem AS. Diagnostic value of apparent diffusion coefficient to differentiate benign from malignant vertebral bone marrow lesions. Egypt J RadiolNucl Med.2013; 44:265–271.
  • Zhou JX, Leeds EN, McKinnon CG, Kumar JK. Characterization of benign and metastatic vertebral compression fractures with quantitative diffusion MR imaging. AJNR 2002; 23:165-170.
  • Luo Z, Litao L, Gu S, Luo X, Li D, Yu L, et al. Standard-b-value vs low-b-value DWI for differentiation of benign and malignant vertebral fractures: a meta-analysis. Br J Radiol. 2016; 89(1058):20150384.
  • Dewan KA, Salama AA, El habashyHM, Khalil AE.Evaluation of benign and malignant vertebral lesions with diffusion weighted magnetic resonance imaging and apparent diffusioncoefficient measurements.Egypt J RadiolNucl Med. 2015; 46:423-433.
  • Wonglaksanapimon S, Chawalparit O, Khumpunnip S, Tritrakarn SO, Chiewvit P, Charnchaowanish P. Vertebral body compression fracture: discriminating benign from malignant causes by diffusion-weighted MR imaging and apparent diffusion coefficient value. J Med Assoc Thai. 2012; 95:81–87.
  • Geith T, Schmidt G, Biffar A, Dietrich O, Duerr HR, ReiserM, et al.Quantitative evaluation of benign and malignant vertebral fractures with diffusion-weighted MRI: what is the optimum combination of b values for ADC-based lesion differentiation with the single-shot turbo spin-echo sequence? AJR Am J Roentgenol. 2014; 203(3):582-8.