Benign versus metastatic vertebral compression fractures: combined diffusion-weighted MRI and MR spectroscopy aids differentiation

Abstract

ADC-MRS analysis provides knowledge of the residual lipid fraction in fractured vertebrae that could aid in the differentiation between benign and metastatic vertebral fractures in low-impact trauma.

Standard-b-value vs low-b-value DWI for differentiation of benign and malignant vertebral fractures: a meta-analysis

“…31 High cellularity in tumour tissue yields lower ADC values than oedematous marrow in benign fractures. 4 However, our study was not designed to explore the accuracy of ADC in the differentiation of benign and malignant vertebral fractures, since our data were not available to fill out cross-tabs in order to assess true positive (TP), true negative (TN), false positive (FP) and false negative (FN) cases.…”

“…Further studies with a larger sample size to determine the sensitivity, specificity, positive-and negative-predictive values of ADC in this aspect would certainly be useful. 4 Fourthly, the diffusion characteristics of the benign vertebral fractures such as osteoporosis, trauma and infection have not been fully investigated separately.…”

“…However, it has been estimated that up to one-third of vertebral compression fractures in patients with known malignancies are benign. [1][2][3][4][5] Although diagnostic imaging has made remarkable progress in recent years, it remains difficult to differentiate benign and malignant vertebral fractures. Appropriate treatment of vertebral fractures requires knowledge of the cause of the fracture.…”

Intravoxel incoherent motion MRI assessment of chemoradiation‐induced pelvic bone marrow changes in cervical cancer and correlation with hematological toxicity

“…Diffusion‐weighted imaging (DWI) of MRI is a valuable technique to study bone marrow microstructural alterations. In DWI, appearances are based on the water‐proton mobility in various conditions and diseases, such as marrow infiltration by myeloma, metastasis, and osteoporotic vertebral fractures . Intravoxel incoherent motion (IVIM), first introduced by Le Bihan, has been recently "rediscovered" as an attractive DWI technique for separating and assessing pure diffusion and perfusion in different organs without administration of contrast media .…”

“…In DWI, appearances are based on the water-proton mobility in various conditions and diseases, such as marrow infiltration by myeloma, metastasis, and osteoporotic vertebral fractures. [11][12][13] Intravoxel incoherent motion (IVIM), first introduced by Le Bihan, has been recently "rediscovered" as an attractive DWI technique for separating and assessing pure diffusion and perfusion in different organs without administration of contrast media. [14][15][16][17][18] The true diffusion, D, measured by IVIM, represents the pure water molecular diffusion in tissue.…”