Comments on “Standard-b-valuevslow-b-value DWI for differentiation of benign and malignant vertebral fractures: a meta-analysis”

Zhang, Si W; Zhong, Ting K; Diao, Huan S

doi:10.1259/bjr.20160224

Cited by 1 publication

(1 citation statement)

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“…Our outcomes were akin to what has been documented in some previous studies. However, there is a disagreement in the literature [6,[12][13][14][15][16] on the role of DWI in distinguishing benign and malignant vertebral fractures, which might be due to use of the lower b-values and dissimilar sequences by previous authors and due to complexity with the overlap of oedema, haematoma, and bone fragmentation in both conditions. As a result, to date, there is no definitive consensus on DWI as the definitive tool for the distinction of benign fractures from pathological fractures [12].…”

Section: Discussionmentioning

confidence: 99%

Role of diffusion-weighted magnetic resonance imaging in the evaluation of vertebral bone marrow lesions

Kaur¹,

Thukral²,

Khanna³

et al. 2020

Pol J Radiol

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Purpose: To evaluate the role of diffusion-weighted magnetic resonance imaging (DW-MRI) in differentiating vertebral marrow pathologies. To determine the sensitivity, specificity, and threshold apparent diffusion coefficient (ADC) values that can aid in the differentiation of malignant from benign bone marrow lesions. Material and methods: This observational study included 100 patients, who underwent MRI examination with a 1.5 Tesla scanner. The ADC values of normal and pathological vertebrae were estimated, and the threshold ADC values were computed by receiver operating characteristic (ROC) analysis. The results were correlated with histopathological diagnosis, clinical follow-up, and other investigations. Statistical analysis was done by employing unpaired two-tailed Student's t-test and the p-value of < 0.05 was deemed as statistically significant. Results: Vertebral bone marrow lesions had a male predominance and there was a predilection towards thoracic and lumbar vertebrae, with L4 being the commonest. Metastasis was the commonest lesion, followed by spondylodiscitis. The mean ADC value of benign pathologies was significantly greater than malignant pathologies (p < 0.05). The threshold value for the demarcation between benign and malignant pathologies was computed to be 1.21 × 10-3 mm 2 /s. DW imaging had sensitivity of 100%, specificity of 92.31%, positive predictive value of 87.5%, and negative predictive value of 100%. Conclusions: Vertebral marrow lesions can be differentiated as benign or malignant with good sensitivity and specificity with the help of DW-ADC maps.

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