OBJECTIVES: To evaluate the diagnostic performance of proton density fat fraction (PDFF) magnetic resonance imaging (MRI) to differentiate between acute benign and neoplastic vertebral compression fractures (VCFs). METHODS: Fifty-seven consecutive patients with 46 acute benign and 41 malignant VCFs were prospectively enrolled in this institutional review board approved study and underwent routine clinical MRI with an additional six-echo modified Dixon sequence of the spine at a clinical 3.0-T scanner. All fractures were categorised as benign or malignant according to either direct bone biopsy or 6-month follow-up MRI. Intravertebral PDFF and PDFFratio (fracture PDFF/normal vertebrae PDFF) for benign and malignant VCFs were calculated using region-of-interest analysis and compared between both groups. Additional receiver operating characteristic and binary logistic regression analyses were performed. RESULTS: Both PDFF and PDFFratio of malignant VCFs were significantly lower compared to acute benign VCFs [PDFF, 3.48 ± 3.30% vs 23.99 ± 11.86% (p < 0.001); PDFFratio, 0.09 ± 0.09 vs 0.49 ± 0.24 (p < 0.001)]. The areas under the curve were 0.98 for PDFF and 0.97 for PDFFratio, yielding an accuracy of 96% and 95% for differentiating between acute benign and malignant VCFs. PDFF remained as the only imaging-based variable to independently differentiate between acute benign and malignant VCFs on multivariate analysis (odds ratio, 0.454; p = 0.005). CONCLUSIONS: Quantitative assessment of PDFF derived from modified Dixon water-fat MRI has high diagnostic accuracy for the differentiation of acute benign and malignant vertebral compression fractures. KEY POINTS: • Chemical-shift-encoding based water-fat MRI can reliably assess vertebral bone marrow PDFF • PDFF is significantly higher in acute benign than in malignant VCFs • PDFF provides high accuracy for differentiating acute benign from malignant VCFs.
OBJECTIVES: To evaluate the diagnostic performance of proton density fat fraction (PDFF) magnetic resonance imaging (MRI) to differentiate between acute benign and neoplastic vertebral compression fractures (VCFs). METHODS: Fifty-seven consecutive patients with 46 acute benign and 41 malignant VCFs were prospectively enrolled in this institutional review board approved study and underwent routine clinical MRI with an additional six-echo modified Dixon sequence of the spine at a clinical 3.0-T scanner. All fractures were categorised as benign or malignant according to either direct bone biopsy or 6-month follow-up MRI. Intravertebral PDFF and PDFFratio (fracture PDFF/normal vertebrae PDFF) for benign and malignant VCFs were calculated using region-of-interest analysis and compared between both groups. Additional receiver operating characteristic and binary logistic regression analyses were performed. RESULTS: Both PDFF and PDFFratio of malignant VCFs were significantly lower compared to acute benign VCFs [PDFF, 3.48 ± 3.30% vs 23.99 ± 11.86% (p < 0.001); PDFFratio, 0.09 ± 0.09 vs 0.49 ± 0.24 (p < 0.001)]. The areas under the curve were 0.98 for PDFF and 0.97 for PDFFratio, yielding an accuracy of 96% and 95% for differentiating between acute benign and malignant VCFs. PDFF remained as the only imaging-based variable to independently differentiate between acute benign and malignant VCFs on multivariate analysis (odds ratio, 0.454; p = 0.005). CONCLUSIONS: Quantitative assessment of PDFF derived from modified Dixon water-fat MRI has high diagnostic accuracy for the differentiation of acute benign and malignant vertebral compression fractures. KEY POINTS: • Chemical-shift-encoding based water-fat MRI can reliably assess vertebral bone marrow PDFF • PDFF is significantly higher in acute benign than in malignant VCFs • PDFF provides high accuracy for differentiating acute benign from malignant VCFs.
Entities:
Keywords:
Chemical shift imaging; Compression fracture; Magnetic resonance imaging; Spinal fractures
Authors: Dimitrios C Karampinos; Stefan Ruschke; Michael Dieckmeyer; Holger Eggers; Hendrik Kooijman; Ernst J Rummeny; Jan S Bauer; Thomas Baum Journal: NMR Biomed Date: 2015-10-01 Impact factor: 4.044
Authors: Donald C Zajick; William B Morrison; Mark E Schweitzer; Joan Antoni Parellada; John A Carrino Journal: Radiology Date: 2005-11 Impact factor: 11.105
Authors: Catherine D G Hines; Huanzhou Yu; Ann Shimakawa; Charles A McKenzie; Jean H Brittain; Scott B Reeder Journal: J Magn Reson Imaging Date: 2009-11 Impact factor: 4.813
Authors: Erik Rud; Daniyal Noor; Kristina Flor Galtung; Fredrik Ottosson; Maciej Jacewicz; Eduard Baco; Peter Mæhre Lauritzen Journal: Eur Radiol Date: 2022-08-08 Impact factor: 7.034
Authors: Frederic Carsten Schmeel; Simon Jonas Enkirch; Julian Alexander Luetkens; Anton Faron; Nils Lehnen; Alois Martin Sprinkart; Leonard Christopher Schmeel; Alexander Radbruch; Ulrike Attenberger; Guido Matthias Kukuk; Petra Mürtz Journal: Clin Neuroradiol Date: 2021-03-31 Impact factor: 3.649
Authors: Tobias Greve; Nithin Manohar Rayudu; Michael Dieckmeyer; Christof Boehm; Stefan Ruschke; Egon Burian; Christopher Kloth; Jan S Kirschke; Dimitrios C Karampinos; Thomas Baum; Karupppasamy Subburaj; Nico Sollmann Journal: Front Endocrinol (Lausanne) Date: 2022-07-11 Impact factor: 6.055
Authors: Sebastien Bacher; Steven David Hajdu; Yael Maeder; Vincent Dunet; Tom Hilbert; Patrick Omoumi Journal: Eur Radiol Date: 2021-05-26 Impact factor: 5.315