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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2024; 34(01): 76-84
DOI: 10.1055/s-0043-1772848
Original Article

Diffusion-Weighted Imaging and Chemical Shift Imaging to Differentiate Benign and Malignant Vertebral Lesion: A Hospital-Based Cross-Sectional Study

Kaneez Fatima
1   Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Suprava Naik
1   Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Mantu Jain
2   Department of Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Sanjeev Kumar Bhoi
3   Department of Neurology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Somnath Padhi
4   Department of Pathology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Nerbadyswari Deep Bag
1   Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Ashutosh Panigrahi
5   Department of Haematology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Sudipta Mohakud 
1   Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
› Author Affiliations Funding None.
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Abstract

Objective The aim of this study was to evaluate the role of diffusion-weighted imaging (DWI) and chemical shift imaging (CSI) for the differentiation of benign and malignant vertebral lesions.

Methods Patients with vertebral lesions underwent routine magnetic resonance imaging (MRI) along with DWI and CSI. Qualitative analysis of the morphological features was done by routine MRI. Quantitative analysis of apparent diffusion coefficient (ADC) from DWI and fat fraction (FF) from CSI was done and compared between benign and malignant vertebral lesions.

Results Seventy-two patients were included. No significant difference was noted in signal intensities of benign and malignant lesions on conventional MRI sequences. Posterior element involvement, paravertebral soft-tissue lesion, and posterior vertebral bulge were common in malignant lesion, whereas epidural/paravertebral collection, absence of posterior vertebral bulge, and multiple compression fractures were common in benign vertebral lesion (p < 0.001). The mean ADC value was 1.25 ± 0.27 mm2/s for benign lesions and 0.9 ± 0.19 mm2/s for malignant vertebral lesions (p ≤ 0.001). The mean value of FF was 12.7 ± 7.49 for the benign group and 4.04 ± 2.6 for the malignant group (p < 0.001). A receiver operating characteristic (ROC) curve analysis showed that an ADC cutoff of 1.05 × 10−3 mm2/s and an FF cutoff of 6.9 can differentiate benign from malignant vertebral lesions, with the former having 86% sensitivity and 82.8% specificity and the latter having 93% sensitivity and 96.6% specificity.

Conclusion The addition of DWI and CSI to routine MRI protocol in patients with vertebral lesions promises to be very helpful in differentiating benign from malignant vertebral lesions when difficulty in qualitative interpretation of conventional MR images arises.

Keywords

diffusion-weighted imaging - chemical shift imaging - fat fraction - Dixon sequence

Informed Consent

Informed consent was obtained from all the participants or their relatives for being included in the study.


Author Contributions

K.F. contributed to data collection, data analysis, literature search, manuscript writing, and manuscript editing. S.N. contributed concept, design, data analysis, literature search, manuscript editing, and manuscript review. M.J. contributed to data collection, data analysis, literature search, manuscript editing, and manuscript review. S.K.B. contributed to data analysis, literature search, manuscript editing, and manuscript review. S.P. contributed to literature search, manuscript editing, and manuscript review. N.D. contributed to literature search, manuscript editing, and manuscript review. A.P. contributed to literature search, manuscript editing, and manuscript review. S.M. contributed to literature search, manuscript editing, and manuscript review.




Publication History

Article published online:
12 September 2023

© 2023. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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