Differentiation of benign and malignant skeletal lesions with quantitative diffusion weighted MRI at 3T

Single-Shot Echo-Planar Diffusion-Weighted MR Imaging at 3T and 1.5T for Differentiation of Benign Vertebral Fracture Edema and Tumor Infiltration

“…Increased SNR can be used to improve contrast or spatial resolution, but the increased effects of the magnetic susceptibility differences of tissues scanned at higher fields can result in signal loss in regions of greater signal de-phasing such as tissue-bone interfaces and tissue-air interfaces (6). Diffusion imaging at 3T MR provides potentially useful information about bone abnormalities in the evaluation of the long bone tumor (7). To the best of our knowledge, a detailed and organized study concerning DWI of the vertebral body in the evaluation of benign marrow edema and malignant tumor infiltration at 3T MR with comparison to 1.5T MR has not been performed.…”

Solid bone tumors of the spine: Diagnostic performance of apparent diffusion coefficient measured using diffusion‐weighted MRI using histology as a reference standard

“…It is more and more applied in oncologic imaging, apparent diffusion coefficient (ADC) being a parameter used to measure the magnitude of diffusion of water molecules within biologic tissues . Previous studies investigated the role of DWI in the differentiation between benign and malignant skeletal conditions, with promising results . However, studies performed in the spine had small sample size or lacked histology comparison .…”

MRI biomarkers in osseous tumors

“…Reports have shown lower ADC in malignant osseous tumors than in benign osseous tumors. Simple bone cysts, and aneurysmal bone cysts, especially have been reported as having high minimum or mean ADC (around 2.0 × 10 −3 mm 2 /s) because of their higher water content . On the other hand, even if benign, several tumors such as nonossifying fibroma and intraosseous epidermoid are reported as having an ADC of less than 1.0 × 10 −3 mm 2 /s .…”

“…Hence, it has been suggested that ADC needs to be interpreted within the context of a tumor's signal intensity on T 2 ‐weighted images (T 2 WI) and DWI . Furthermore, biologically aggressive benign lesions, such as giant cell tumor (GCT), osteoblastoma, and Langerhans cell histiocytosis, have also been reported to have lower minimum and mean ADC, which considerably overlap with the value of malignant lesions …”

“…Variable low ADCs have been reported in osteosarcoma (OS), Ewing sarcoma, plasmacytoma, multiple myeloma (MM), lymphoma, and bone metastases . Among them, small round cell tumors like Ewing sarcoma, plasmacytoma, MM, and lymphoma tend to have somewhat consistently lower values around 0.9 × 10 −3 mm 2 /s, with some overlapping with the range of normal red marrow . In OS, variable ADC can be measured according to histological features (Fig.…”