PURPOSE: Several publications have reported that the apparent diffusion coefficient is generally lower in metastatically affected vertebrae. Therefore, metastases are represented in diffusion-weighted images by increased signal intensity in comparison to unaffected vertebrae. However, there were indications that metastases due to prostate cancer may differ from this. Therefore, the contrast behavior of vertebral metastases due to prostate cancer or tumors with another histology are to be systematically studied using diffusion-weighted images. The present study is intended to examine whether the two groups differed and whether possible differences depended on the degree of sclerosis. MATERIALS AND METHOD: In a retrospective study the vertebral metastases of patients with prostate cancer (n = 18) were compared to those of patients with tumors of another histology (n = 20). A steady-state free precession sequence was used for the diffusion-weighted imaging. Additionally, a T1 weighted sequence before and after administration of contrast agent as well as a fat suppressed T2 weighted sequence were performed. The contrast behavior of the metastases was evaluated for all four sequences and was compared to that of the unaffected parts of the vertebra. RESULTS: In 18 patients of the tumor group, the vertebral metastases showed positive contrast in the diffusion-weighted images, and 2 had minimally negative contrast up to - 0.04. In the prostate cancer group, the contrast was positive in 9 patients and negative in 9. 6 of the metastases with negative contrast had an osteoblastic metastasization, 1 had an osteolysis, and 1 had a normal finding in the conventional X-ray image. Between the tumor group and the prostate cancer group, the medians of the contrasts were not significantly different (p = 0.054). CONCLUSION: In general, the metastatically affected vertebrae appear hyperintense in the diffusion-weighted images. This observation is only true for some vertebral metastases due to prostate cancer. The cause for this seems to be the degree of sclerosis of the metastases. Thus, it cannot be generally deduced from the hypointensity in diffusion-weighted images that a lesion is benign.
PURPOSE: Several publications have reported that the apparent diffusion coefficient is generally lower in metastatically affected vertebrae. Therefore, metastases are represented in diffusion-weighted images by increased signal intensity in comparison to unaffected vertebrae. However, there were indications that metastases due to prostate cancer may differ from this. Therefore, the contrast behavior of vertebral metastases due to prostate cancer or tumors with another histology are to be systematically studied using diffusion-weighted images. The present study is intended to examine whether the two groups differed and whether possible differences depended on the degree of sclerosis. MATERIALS AND METHOD: In a retrospective study the vertebral metastases of patients with prostate cancer (n = 18) were compared to those of patients with tumors of another histology (n = 20). A steady-state free precession sequence was used for the diffusion-weighted imaging. Additionally, a T1 weighted sequence before and after administration of contrast agent as well as a fat suppressed T2 weighted sequence were performed. The contrast behavior of the metastases was evaluated for all four sequences and was compared to that of the unaffected parts of the vertebra. RESULTS: In 18 patients of the tumor group, the vertebral metastases showed positive contrast in the diffusion-weighted images, and 2 had minimally negative contrast up to - 0.04. In the prostate cancer group, the contrast was positive in 9 patients and negative in 9. 6 of the metastases with negative contrast had an osteoblastic metastasization, 1 had an osteolysis, and 1 had a normal finding in the conventional X-ray image. Between the tumor group and the prostate cancer group, the medians of the contrasts were not significantly different (p = 0.054). CONCLUSION: In general, the metastatically affected vertebrae appear hyperintense in the diffusion-weighted images. This observation is only true for some vertebral metastases due to prostate cancer. The cause for this seems to be the degree of sclerosis of the metastases. Thus, it cannot be generally deduced from the hypointensity in diffusion-weighted images that a lesion is benign.
Authors: Frederic Carsten Schmeel; Julian Alexander Luetkens; Peter Johannes Wagenhäuser; Michael Meier-Schroers; Daniel Lloyd Kuetting; Andreas Feißt; Jürgen Gieseke; Leonard Christopher Schmeel; Frank Träber; Hans Heinz Schild; Guido Matthias Kukuk Journal: Eur Radiol Date: 2018-01-08 Impact factor: 5.315
Authors: Andreas Biffar; Andrea Baur-Melnyk; Gerwin P Schmidt; Maximilian F Reiser; Olaf Dietrich Journal: Eur Radiol Date: 2010-06-17 Impact factor: 5.315
Authors: Christina Plank; Anke Koller; Christina Mueller-Mang; Roland Bammer; Majda M Thurnher Journal: Neuroradiology Date: 2007-10-19 Impact factor: 2.804
Authors: J Yamamura; G Salomon; R Buchert; A Hohenstein; J Graessner; H Huland; M Graefen; G Adam; U Wedegaetner Journal: Radiol Res Pract Date: 2010-07-20
Authors: Frederic Carsten Schmeel; Asadeh Lakghomi; Nils Christian Lehnen; Robert Haase; Mohammed Banat; Johannes Wach; Nikolaus Handke; Hartmut Vatter; Alexander Radbruch; Ulrike Attenberger; Julian Alexander Luetkens Journal: Diagnostics (Basel) Date: 2021-12-30