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Single-Shot Echo-Planar Diffusion-Weighted MR Imaging at 3T and 1.5T for Differentiation of Benign Vertebral Fracture Edema and Tumor Infiltration

  • Park, Hee Jin (Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Lee, So Yeon (Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Rho, Myung Ho (Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Chung, Eun Chul (Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Kim, Mi Sung (Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Kwon, Heon Ju (Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Youn, In Young (Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine)
  • Received : 2016.03.11
  • Accepted : 2016.06.10
  • Published : 2016.09.01

Abstract

Objective: To compare the apparent diffusion coefficient (ADC) value using single-shot echo-planar imaging sequences at 3T and 1.5T for differentiation of benign fracture edema and tumor infiltration of the vertebral body. Materials and Methods: A total of 46 spinal examinations were included in the 1.5T MRI group, and a total of 40 spinal examinations were included in the 3T MRI group. The ADC values of the lesion were measured and calculated. The diagnostic performance of the conventional MR image containing sagittal T2-weighted fat saturated image and each diffusion weighted image (DWI) with an ADC value with different b values were evaluated. Results: The mean ADC value of the benign lesions was higher than that of the malignant lesions on 1.5T and 3T (p < 0.05). The sensitivity of the diagnostic performance was higher with an additional DWI in both 1.5T and 3T, but the sensitivities were similar with the addition of b values of 400 and 1000. The specificities of the diagnostic performances did not show significant differences (p value > 0.05). The diagnostic accuracies were higher when either of the DWIs (b values of 400 and 1000) was added to routine MR image for 1.5T and 3T. Statistical differences between 1.5T and 3T or between b values of 400 and 1000 were not seen. Conclusion: The ADC values of the benign lesions were significantly higher than those of the malignant lesions on 1.5T and 3T. There was no statistically significant difference in the diagnostic performances when either of the DWIs (b values of 400 and 1000) was added to the routine MR image for 1.5T and 3T.

Keywords

References

  1. Oztekin O, Ozan E, Hilal Adibelli Z, Unal G, Abali Y. SSHEPI diffusion-weighted MR imaging of the spine with low b values: is it useful in differentiating malignant metastatic tumor infiltration from benign fracture edema? Skeletal Radiol 2009;38:651-658 https://doi.org/10.1007/s00256-009-0668-z
  2. Kim YP, Kannengiesser S, Paek MY, Kim S, Chung TS, Yoo YH, et al. Differentiation between focal malignant marrowreplacing lesions and benign red marrow deposition of the spine with $T2^*$-corrected fat-signal fraction map using a three-echo volume interpolated breath-hold gradient echo Dixon sequence. Korean J Radiol 2014;15:781-791 https://doi.org/10.3348/kjr.2014.15.6.781
  3. Herneth AM, Philipp MO, Naude J, Funovics M, Beichel RR, Bammer R, et al. Vertebral metastases: assessment with apparent diffusion coefficient. Radiology 2002;225:889-894 https://doi.org/10.1148/radiol.2253011707
  4. Baur A, Stabler A, Bruning R, Bartl R, Krodel A, Reiser M, et al. Diffusion-weighted MR imaging of bone marrow: differentiation of benign versus pathologic compression fractures. Radiology 1998;207:349-356 https://doi.org/10.1148/radiology.207.2.9577479
  5. Castillo M. Diffusion-weighted imaging of the spine: is it reliable? AJNR Am J Neuroradiol 2003;24:1251-1253
  6. Phalke VV, Gujar S, Quint DJ. Comparison of 3.0 T versus 1.5 T MR: imaging of the spine. Neuroimaging Clin N Am 2006;16:241-248, ix https://doi.org/10.1016/j.nic.2006.02.005
  7. Ahlawat S, Khandheria P, Subhawong TK, Fayad LM. Differentiation of benign and malignant skeletal lesions with quantitative diffusion weighted MRI at 3T. Eur J Radiol 2015;84:1091-1097 https://doi.org/10.1016/j.ejrad.2015.02.019
  8. Kuhl CK, Textor J, Gieseke J, von Falkenhausen M, Gernert S, Urbach H, et al. Acute and subacute ischemic stroke at high-field-strength (3.0-T) diffusion-weighted MR imaging: intraindividual comparative study. Radiology 2005;234:509-516 https://doi.org/10.1148/radiol.2342031323
  9. Rosner B. Fundamentals of biostatistics. 6th ed. Belmont, CA: Duxbury Press, 2005
  10. Viera AJ, Garrett JM. Understanding interobserver agreement: the kappa statistic. Fam Med 2005;37:360-363
  11. Tang G, Liu Y, Li W, Yao J, Li B, Li P. Optimization of b value in diffusion-weighted MRI for the differential diagnosis of benign and malignant vertebral fractures. Skeletal Radiol 2007;36:1035-1041 https://doi.org/10.1007/s00256-007-0358-7
  12. Lang P, Wendland MF, Saeed M, Gindele A, Rosenau W, Mathur A, et al. Osteogenic sarcoma: noninvasive in vivo assessment of tumor necrosis with diffusion-weighted MR imaging. Radiology 1998;206:227-235 https://doi.org/10.1148/radiology.206.1.9423677
  13. Spuentrup E, Buecker A, Adam G, van Vaals JJ, Guenther RW. Diffusion-weighted MR imaging for differentiation of benign fracture edema and tumor infiltration of the vertebral body. AJR Am J Roentgenol 2001;176:351-358 https://doi.org/10.2214/ajr.176.2.1760351
  14. Castillo M, Arbelaez A, Smith JK, Fisher LL. Diffusion-weighted MR imaging offers no advantage over routine noncontrast MR imaging in the detection of vertebral metastases. AJNR Am J Neuroradiol 2000;21:948-953
  15. Balliu E, Vilanova JC, Pelaez I, Puig J, Remollo S, Barcelo C, et al. Diagnostic value of apparent diffusion coefficients to differentiate benign from malignant vertebral bone marrow lesions. Eur J Radiol 2009;69:560-566 https://doi.org/10.1016/j.ejrad.2007.11.037
  16. Geith T, Schmidt G, Biffar A, Dietrich O, Durr HR, Reiser M, et al. Comparison of qualitative and quantitative evaluation of diffusion-weighted MRI and chemical-shift imaging in the differentiation of benign and malignant vertebral body fractures. AJR Am J Roentgenol 2012;199:1083-1092 https://doi.org/10.2214/AJR.11.8010
  17. Dietrich O, Biffar A, Reiser MF, Baur-Melnyk A. Diffusionweighted imaging of bone marrow. Semin Musculoskelet Radiol 2009;13:134-144 https://doi.org/10.1055/s-0029-1220884
  18. Lee SY, Jee WH, Jung JY, Park MY, Kim SK, Jung CK, et al. Differentiation of malignant from benign soft tissue tumours: use of additive qualitative and quantitative diffusionweighted MR imaging to standard MR imaging at 3.0 T. Eur Radiol 2016;26:743-754 https://doi.org/10.1007/s00330-015-3878-x
  19. Subhawong TK, Jacobs MA, Fayad LM. Diffusion-weighted MR imaging for characterizing musculoskeletal lesions. Radiographics 2014;34:1163-1177 https://doi.org/10.1148/rg.345140190
  20. Yuan YH, Xiao EH, He Z, Xiang J, Tang KL, Yan RH, et al. MR diffusion-weighed imaging of rabbit liver. World J Gastroenterol 2005;11:5506-5511 https://doi.org/10.3748/wjg.v11.i35.5506

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