American Journal of Neuroradiology 23:165-170, January 2002
© 2002 American Society of Neuroradiology
SPINE
Characterization of Benign and Metastatic Vertebral Compression Fractures with Quantitative Diffusion MR Imaging
a Department of Diagnostic Radiology, University of Texas M. D. Anderson Cancer Center, Houston, TX
b Applied Science Laboratory, GE Medical Systems, Milwaukee, WI
Address reprint requests to Xiaohong Joe Zhou, PhD, Department of Diagnostic Radiology, M. D. Anderson Cancer Center, Box 057, 1515 Holcombe Boulevard, Houston, TX 77030
BACKGROUND AND PURPOSE: Conventional imaging techniques cannot be used to unambiguously and reliably differentiate malignant from benign vertebral compression fractures. Our hypothesis is that these malignant and benign vertebral lesions can be better distinguished on the basis of tissue apparent diffusion coefficients (ADCs). The purpose of this study was to test this hypothesis by using a quantitative diffusion imaging technique.
METHODS: Twenty-seven patients with known cancer and suspected metastatic vertebral lesions underwent 1.5-T conventional T1-weighted, T2-weighted, and contrast-enhanced T1-weighted imaging to identify the lesions. Diffusion-weighted images of the areas of interest were acquired by using a fast spin-echo diffusion pulse sequence with b values of 0–250 s/mm2. The abnormal regions on the diffusion-weighted images were outlined by using the conventional images as guides, and the ADC values were calculated. On the basis of pathologic results and clinical findings, the cases were divided into two categories: benign compression fractures and metastatic lesions. The ADC values for each category were combined and plotted as histograms; this procedure was followed by statistical analysis.
RESULTS: The patient group had 12 benign fractures and 15 metastases. The mean ADC values, as obtained from the histograms, were (1.9 ± 0.3) x 10-4 mm2/s and (3.2 ± 0.5) x 10-4 mm2/s for metastases and benign fractures, respectively.
CONCLUSION: Our results indicate that quantitative ADC mapping, instead of qualitative diffusion-weighted imaging, can provide valuable information in differentiating benign vertebral fractures from metastatic lesions.
This article has been cited by other articles:
 |
|
 |
|
  A. Y. Oner, L. Aggunlu, S. Akpek, T. Tali, and A. Celik Diffusion-Weighted Imaging of the Appendicular Skeleton with a Non Carr-Purcell-Meiboom-Gill Single-Shot Fast Spin-Echo Sequence Am. J. Roentgenol., December 1, 2007; 189(6): 1494 - 1501. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H.G. Hatipoglu, A. Selvi, D. Ciliz, and E. Yuksel Quantitative and Diffusion MR Imaging as a New Method To Assess Osteoporosis AJNR Am. J. Neuroradiol., November 1, 2007; 28(10): 1934 - 1937. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Dammers, H. W C Bijvoet, M. J Driesse, and C. C J Avezaat Occurrence of malignant vertebral fractures in an emergency room setting Emerg. Med. J., October 1, 2007; 24(10): 707 - 709. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A.J. Nemeth, J.W. Henson, M.E. Mullins, R.G. Gonzalez, and P.W. Schaefer Improved Detection of Skull Metastasis with Diffusion-Weighted MR Imaging AJNR Am. J. Neuroradiol., June 1, 2007; 28(6): 1088 - 1092. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D.-M. Koh and D. J. Collins Diffusion-Weighted MRI in the Body: Applications and Challenges in Oncology Am. J. Roentgenol., June 1, 2007; 188(6): 1622 - 1635. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A.Y. Oner, T. Tali, F. Celikyay, A. Celik, and P. Le Roux Diffusion-Weighted Imaging of the Spine with a Non-Carr-Purcell-Meiboom-Gill Single-Shot Fast Spin-Echo Sequence: Initial Experience AJNR Am. J. Neuroradiol., March 1, 2007; 28(3): 575 - 580. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W.K. Erly, E.S. Oh, and E.K. Outwater The Utility of In-Phase/Opposed-Phase Imaging in Differentiating Malignancy from Acute Benign Compression Fractures of the Spine AJNR Am. J. Neuroradiol., June 1, 2006; 27(6): 1183 - 1188. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. M. Fayad, S. Kawamoto, I. R. Kamel, D. A. Bluemke, J. Eng, F. J. Frassica, and E. K. Fishman Distinction of Long Bone Stress Fractures from Pathologic Fractures on Cross-Sectional Imaging: How Successful Are We? Am. J. Roentgenol., October 1, 2005; 185(4): 915 - 924. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Maeda, H. Sakuma, S. E. Maier, and K. Takeda Quantitative Assessment of Diffusion Abnormalities in Benign and Malignant Vertebral Compression Fractures by Line Scan Diffusion-Weighted Imaging Am. J. Roentgenol., November 1, 2003; 181(5): 1203 - 1209. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. V. Mulkern, R. B. Schwartz, X. J. Zhou, N. E. Leeds, A. J. Kumar, and G. C. McKinnon In Re: Characterization of Benign and Metastatic Vertebral Compression Fractures with Quantitative Diffusion MR Imaging AJNR Am. J. Neuroradiol., August 1, 2003; 24(7): 1489 - 1491. [Full Text] [PDF]
|
|
|
|
|
|
M. Castillo Diffusion-Weighted Imaging of the Spine: Is It Reliable? AJNR Am. J. Neuroradiol., June 1, 2003; 24(6): 1251 - 1253. [Full Text] [PDF]
|
|
|
|
|
|
R. Bammer, A. M. Herneth, S. E. Maier, K. Butts, R. W. Prokesch, H. M. Do, S. W. Atlas, and M. E. Moseley Line Scan Diffusion Imaging of the Spine AJNR Am. J. Neuroradiol., January 1, 2003; 24(1): 5 - 12. [Abstract] [Full Text] [PDF]
|
|