Differentiation of benign and malignant skeletal lesions with quantitative diffusion weighted MRI at 3 T

Shivani Ahlawat, Paras Khandheria, Ty K. Subhawong, Laura M Fayad

Research output: Contribution to journalArticle

Abstract

Objectives To investigate the accuracy of quantitative diffusion-weighted imaging with apparent diffusion coefficient (ADC) mapping for characterizing bone lesions as benign or malignant. Methods At 3 T, 31 subjects with intramedullary lesions imaged by DWI (b-values 50, 400, 800 s/mm2) were included. ADC values (minimum, mean, maximum) were recorded by three observers independently. Interobserver variability and differences between ADC values in benign and malignant lesions were assessed (unpaired t-test, receiver operating characteristic (ROC) analysis). Results Of 31 lesions, 18 were benign (osteoblastic (n = 1), chondroid (n = 6), cysts (n = 4), hemangiomatosis (n = 1), fibrous (n = 3), eosinophilic granuloma (n = 1), giant cell tumor (n = 1), osteomyelitis (n = 1)) and 13 were malignant (primary (n = 5), metastases (n = 8)). Overall, there were higher minimum (1.27 × 10-3 mm2/s vs 0.68 × 10-3 mm2/s, p <0.001), mean (1.68 × 10-3 mm2/s vs 1.13 × 10-3 mm2/s, p <0.001), and maximum (2.09 × 10-3 mm2/s vs 1. 7 × 10-3 mm2/s, p = 0.03). ADC values in benign lesions compared with those in malignancies. ROC analysis revealed areas under the curve for minimum, mean, and maximum ADC values of 0.91, 0.85, and 0.71, respectively. ADC measurements were made with high inter-observer concordance (ρ = 0.83-0.96). Conclusion Quantitative ADC maps may have predictive value for the characterization of bone lesions. Benign lesions generally have higher minimum, mean, and maximum ADC values than malignancies, with the minimum value offering the highest accuracy for characterization.

Original languageEnglish (US)
Pages (from-to)1091-1097
Number of pages7
JournalEuropean Journal of Radiology
Volume84
Issue number6
DOIs
StatePublished - Jun 1 2015

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Diffusion Magnetic Resonance Imaging
ROC Curve
Eosinophilic Granuloma
Bone and Bones
Giant Cell Tumors
Observer Variation
Osteomyelitis
Area Under Curve
Cysts
Neoplasms
Neoplasm Metastasis

Keywords

  • ADC map
  • Bone tumors
  • Diffusion-weighted imaging
  • Musculoskeletal

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

Cite this

Differentiation of benign and malignant skeletal lesions with quantitative diffusion weighted MRI at 3 T. / Ahlawat, Shivani; Khandheria, Paras; Subhawong, Ty K.; Fayad, Laura M.

In: European Journal of Radiology, Vol. 84, No. 6, 01.06.2015, p. 1091-1097.

Research output: Contribution to journalArticle

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AB - Objectives To investigate the accuracy of quantitative diffusion-weighted imaging with apparent diffusion coefficient (ADC) mapping for characterizing bone lesions as benign or malignant. Methods At 3 T, 31 subjects with intramedullary lesions imaged by DWI (b-values 50, 400, 800 s/mm2) were included. ADC values (minimum, mean, maximum) were recorded by three observers independently. Interobserver variability and differences between ADC values in benign and malignant lesions were assessed (unpaired t-test, receiver operating characteristic (ROC) analysis). Results Of 31 lesions, 18 were benign (osteoblastic (n = 1), chondroid (n = 6), cysts (n = 4), hemangiomatosis (n = 1), fibrous (n = 3), eosinophilic granuloma (n = 1), giant cell tumor (n = 1), osteomyelitis (n = 1)) and 13 were malignant (primary (n = 5), metastases (n = 8)). Overall, there were higher minimum (1.27 × 10-3 mm2/s vs 0.68 × 10-3 mm2/s, p <0.001), mean (1.68 × 10-3 mm2/s vs 1.13 × 10-3 mm2/s, p <0.001), and maximum (2.09 × 10-3 mm2/s vs 1. 7 × 10-3 mm2/s, p = 0.03). ADC values in benign lesions compared with those in malignancies. ROC analysis revealed areas under the curve for minimum, mean, and maximum ADC values of 0.91, 0.85, and 0.71, respectively. ADC measurements were made with high inter-observer concordance (ρ = 0.83-0.96). Conclusion Quantitative ADC maps may have predictive value for the characterization of bone lesions. Benign lesions generally have higher minimum, mean, and maximum ADC values than malignancies, with the minimum value offering the highest accuracy for characterization.

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