Correlation of quantitative diffusion weighted MR imaging between benign, malignant chondrogenic and malignant non-chondrogenic bone tumors with histopathologic type

Abstract

Objectives This study aims to determine the diffusion on weighted imaging which may help in providing characterization of Apparent Diffusion Coefficient (ADC) values in benign, malignant chondrogenic and malignant non-chondrogenic bone tumors. Material and methods A retrospective study with 84 samples was conducted from October 2017 to December 2019. The samples consisted of 44 males and 40 females; the age range of 10–73 years (mean age of 32.7 years old). A Diffusion-weighted Magnetic Resonance (MR) utilizes a single-shot echo-planar imaging sequence technique with the 3T MR Scanner. We classified the types of tumors into benign, malignant chondrogenic and malignant non-chondrogenic bone tumors. The mean of ADC values from the area with lowest ADC values was selected for statistical analysis. ADC values were compared between benign, malignant chondrogenic and malignant non-chondrogenic bone tumors. Therefore, Receiver Operating Curve (ROC) analysis was done to determine optimal cut-off values. The correlation of ADC values between benign, malignant chondrogenic and malignant non-chondrogenic bone tumor with histopathologic type was also evaluated. Results The mean of ADC values from the area of benign, malignant chondrogenic and malignant non-chondrogenic bone tumor were 1.55 × 10 −3 mm 2 /s, 1.84 × 10 −3 mm 2 /s and 1.12 × 10 −3 mm 2 /s respectively. As a matter of fact, there was a significant difference between benign and malignant bone tumor with cut-off value of 1.15 × 10 −3 mm 2 /s and had a sensitivity of 82%, and a specificity of 92.3%. Moreover, a significant correlation was also found between ADC values with the histopathology type of bone tumors. Conclusion The ADC values of benign and malignant (chondrogenic and non-chondrogenic groups) bone tumors are different. Thus, the measurement of ADC values improves the accuracy of the diagnosis of bone tumors.

Characteristic of Apparent Diffusion Coefficient and Time Intensity Curve Analysis of Dynamic Contrast Enhanced MRI in Osteosarcoma Histopathologic Subtypes

“…The highest mean of ADC value was found in chondroblastic subtype. This result was similar to a study from Yakushiji et al, in the extent of the tumor cells are more freely dispersed among the chondroid matrices in chondroblastic osteosarcoma 22,23 . This study pointed to lower ADC values for osteoblastic, small cell, giant cell rich type OS lesions reflecting higher cellularity of the tumor osteoid matrix, small round cells and giant-cell stroma respectively.…”

“…In this study, the highest mean of ADC value was found in chondroblastic subtype. This result was similar to study by Setiawati et al in 2021, where the mean of ADC value in malignant chondrogenic bone tumor was 1.84x10 -3 mm 2 . Moreover, another study by Yakushiji et al in 2009 stated that chondroblastic osteosarcoma had a higher mean of ADC value than other osteosarcoma subtypes 21,23 .…”

“…osteoid, chondroid or fibrous, and the largest composition is the osteoid matrix. The differentiation in osteosarcoma will determine the histopatological subtype 21 . In this study, the most predominant osteosarcoma was osteoblastic subtype.…”

Apparent Diffusion Coefficient and Time Intensity Curve Values from Dynamic Contrast Enhancement (DCE) MRI in Osteosarcoma Histopathological Subtypes

“…4 Another study conducted by Setiawati et al in 2021 stated that the increase of osteoid matrix between chondroid matrices will increase DWI restriction and decrease ADC value. 8 The highest mean ADC value was found in chondroblastic subtype. This result was similar to study result.by Setiawati et al in 2021, where malignant chondrogenic bone tumor mean ADC value was 1.84x10 -3 mm 2 and another study by Yakushiji et al in 2009 stated that chondroblastic osteosarcoma had higher mean ADC value compared with other osteosarcoma subtypes.…”

“…This in accordance with typical characteristics of osteosarcoma. 4,8 Osteosarcoma histopathological examination results were classified into several subtypes (Table 2). The most prevalent osteosarcoma subtypes were osteoblastic osteosarcoma in 20 patients (46.5%), followed by chondroblastic subtype in 8 patients (18.6%) and giant cell rich subtype in 6 patients (14.0%).…”