J Cao1, L Xiao2, B He3, G Zhang3, J Dong2, Y Wu2, H Xie2, G Wang2, X Lin4. 1. Shandong Medical Imaging Research Institute, Shandong University, No. 44 West Wenhua Road, Jinan, 250012 PR China; Central Hospital of Zibo, No. 54 West Gongqingtuan Road, Zibo, 255020 PR China. 2. Shandong Medical Imaging Research Institute, Shandong University, No. 44 West Wenhua Road, Jinan, 250012 PR China. 3. Central Hospital of Zibo, No. 54 West Gongqingtuan Road, Zibo, 255020 PR China. 4. Shandong Medical Imaging Research Institute, Shandong University, No. 44 West Wenhua Road, Jinan, 250012 PR China. Electronic address: linxt616@163.com.
Abstract
AIM: To determine the diagnostic value of combined diffusion-weighted imaging (DWI) with dynamic contrast enhancement magnetic resonance imaging (DCE-MRI) in differentiating malignant from benign bone lesions. MATERIALS AND METHODS: DWI and DCE-MRI were performed in 36 patients (14 were benign and 22 were malignant). The mean apparent diffusion coefficient (ADC) values and signal enhanced extent (SEE), slope value, and time-signal intensity curve (TIC) type were recorded by two observers. Between-group comparison was made using the independent sample t-test and receiver-operating characteristic (ROC) analysis. RESULTS: There was a significant difference between the mean ADC value of the benign ([1.75±0.50]×10-3 mm2/s) and malignant ([1.11±0.47]×10-3 mm2/s) groups (p=0.001). The threshold ADC value of ≤1.10×10-3 mm2/s resulted in a sensitivity of 77.3%, a specificity of 92.9%, and an accuracy of 85.1%. A type III curve was found in 23 cases (21 malignant and two benign), a type II curve was seen in six cases (one malignant and five benign), and a type I curve in seven cases (all were benign). The SEE and slope values in the benign and malignant groups were 227.96±172.08, 325.60±125.86 (p=0.058); 0.97±0.67%/s, 3.19±3.20%/s (p=0.016), respectively. ROC analysis showed a sensitivity of 95.5%, a specificity of 85.7%, and an accuracy of 90.6% for malignancy, based on a slope cut-off value of >1.46%/s. Combining ADC and slope values resulted in a sensitivity of 100%, a specificity of 85.7%, and an accuracy of 92.9%. CONCLUSIONS: Both DWI and DCE-MRI showed promising results for differentiating malignant from benign bone lesions. A combination of DWI and DCE-MRI was the most valuable of the three.
AIM: To determine the diagnostic value of combined diffusion-weighted imaging (DWI) with dynamic contrast enhancement magnetic resonance imaging (DCE-MRI) in differentiating malignant from benign bone lesions. MATERIALS AND METHODS: DWI and DCE-MRI were performed in 36 patients (14 were benign and 22 were malignant). The mean apparent diffusion coefficient (ADC) values and signal enhanced extent (SEE), slope value, and time-signal intensity curve (TIC) type were recorded by two observers. Between-group comparison was made using the independent sample t-test and receiver-operating characteristic (ROC) analysis. RESULTS: There was a significant difference between the mean ADC value of the benign ([1.75±0.50]×10-3 mm2/s) and malignant ([1.11±0.47]×10-3 mm2/s) groups (p=0.001). The threshold ADC value of ≤1.10×10-3 mm2/s resulted in a sensitivity of 77.3%, a specificity of 92.9%, and an accuracy of 85.1%. A type III curve was found in 23 cases (21 malignant and two benign), a type II curve was seen in six cases (one malignant and five benign), and a type I curve in seven cases (all were benign). The SEE and slope values in the benign and malignant groups were 227.96±172.08, 325.60±125.86 (p=0.058); 0.97±0.67%/s, 3.19±3.20%/s (p=0.016), respectively. ROC analysis showed a sensitivity of 95.5%, a specificity of 85.7%, and an accuracy of 90.6% for malignancy, based on a slope cut-off value of >1.46%/s. Combining ADC and slope values resulted in a sensitivity of 100%, a specificity of 85.7%, and an accuracy of 92.9%. CONCLUSIONS: Both DWI and DCE-MRI showed promising results for differentiating malignant from benign bone lesions. A combination of DWI and DCE-MRI was the most valuable of the three.