E Oh1, Y C Yoon2, J H Kim3, K Kim4. 1. Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea. 2. Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea. Electronic address: ycyoon@skku.edu. 3. Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. 4. Department of Biostatistics and Clinical Epidemiology, Samsung Medical Center, Seoul, Republic of Korea.
Abstract
AIM: To evaluate and compare the diagnostic performance of quantitative parameters derived from diffusion-weighted imaging (DWI) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in differentiating benign and malignant bone tumours. MATERIALS AND METHODS: Fifty-five patients (age range, 21-82 years; mean age, 55 years) underwent pretreatment MRI. Apparent diffusion coefficient (ADC) values were calculated by DWI. The DCE-MRI data were analysed for the volume transfer constant (Ktrans), extravascular extracellular volume fraction (Ve), and volume rate constant (Kep), and Ktrans/ADC ratio. Each parameter's performance was evaluated using the area under the receiver operating characteristic (ROC) curv (AUC), and their AUCs were compared. ROC curves were analysed and each parameter's optimal cut-off value was determined, from which each parameter was evaluated for sensitivity, specificity, accuracy, and positive and negative predictive values. The odds ratio (OR) with 95% confidence interval for detecting malignant bone lesions after adjusting the age factor of each parameter was estimated. RESULTS: All parameter values (except Ve) were significantly different between benign and malignant bone tumours (p<0.05). The Ktrans had a significantly greater AUC than Ve (p=0.03). The Ktrans/ADC and Kep had the best sensitivity (0.917) and specificity (0.632), respectively. The Kep and Ktrans/ADC had the best positive (0.811) and negative (0.769) predictive values, respectively. The OR was highest for Ktrans/ADC (17.38; p=0.0013). CONCLUSION: The Ktrans, Kep, ADC, and Ktrans/ADC could help to detect malignant lesions from bone tumours and Ktrans/ADC appears to be the superior variable among them.
AIM: To evaluate and compare the diagnostic performance of quantitative parameters derived from diffusion-weighted imaging (DWI) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in differentiating benign and malignant bone tumours. MATERIALS AND METHODS: Fifty-five patients (age range, 21-82 years; mean age, 55 years) underwent pretreatment MRI. Apparent diffusion coefficient (ADC) values were calculated by DWI. The DCE-MRI data were analysed for the volume transfer constant (Ktrans), extravascular extracellular volume fraction (Ve), and volume rate constant (Kep), and Ktrans/ADC ratio. Each parameter's performance was evaluated using the area under the receiver operating characteristic (ROC) curv (AUC), and their AUCs were compared. ROC curves were analysed and each parameter's optimal cut-off value was determined, from which each parameter was evaluated for sensitivity, specificity, accuracy, and positive and negative predictive values. The odds ratio (OR) with 95% confidence interval for detecting malignant bone lesions after adjusting the age factor of each parameter was estimated. RESULTS: All parameter values (except Ve) were significantly different between benign and malignant bone tumours (p<0.05). The Ktrans had a significantly greater AUC than Ve (p=0.03). The Ktrans/ADC and Kep had the best sensitivity (0.917) and specificity (0.632), respectively. The Kep and Ktrans/ADC had the best positive (0.811) and negative (0.769) predictive values, respectively. The OR was highest for Ktrans/ADC (17.38; p=0.0013). CONCLUSION: The Ktrans, Kep, ADC, and Ktrans/ADC could help to detect malignant lesions from bone tumours and Ktrans/ADC appears to be the superior variable among them.
Authors: Koeun Lee; Ho Young Park; Kyung Won Kim; Amy Junghyun Lee; Min A Yoon; Eun Jin Chae; Jeong Hyun Lee; Hye Won Chung Journal: J Clin Orthop Trauma Date: 2019-05-29