Diffusion‐weighted MRI and in‐phase/opposed‐phase sequences in the assessment of bone tumors

Abstract

Diffusion-weighted and in-phase/opposed-phase imaging might be used in addition to conventional MRI as a routine tool for differentiation of benign and malignant tumors. J. Magn. Reson. Imaging 2016;44:565-572.

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

“…As shown by our and previous studies, giant cell tumors, which are histopathologically benign despite being locally aggressive, have very low ADC values, similar to malignant lesions, probably due to their high cellularity . Nevertheless, in clinical practice, benign primary tumors often show clear nonaggressive characteristics such as a distinct area of transition between the normal bone and the lesion, an undamaged cortex, and the absence of periosteal reaction .…”

“…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 .…”

“…8 Previous studies investigated the role of DWI in the differentiation between benign and malignant skeletal conditions, with promising results. [9][10][11][12][13][14][15][16][17][18][19] However, studies performed in the spine had small sample size or lacked histology comparison. 11,12,14,16,19 Moreover, several of these studies focused on the differentiation between osteoporotic and malignant vertebral fractures, in which ADC measurement is affected by bone marrow edema related to compression fracture itself.…”

Diffusion magnetic resonance imaging: A molecular imaging tool caught between hope, hype and the real world of “personalized oncology”

“…Also, DWI has been applied to differentiate benign bone disease, bone tumors and tumor like bone lesions, for instance Ewing’s sarcoma from osteomyelitis and for predicting length of tumor infiltrated marrow (Figure 13)[89]. Moreover, measurement of ADC values can be used in the follow-up of tumors and their response to therapy[89,90]. ADC values greater than 0.77 × 10 -3 mm 2 /s is suggestive of neoplastic marrow infiltration.…”

“…This cut-off value is shown to have a sensitivity of 85% and specificity of 90% for predicting neoplastic marrow infiltration. For soft tissue tumors, a threshold ADC value of 1.34 × 10 -3 mm 2 /s is used in differentiating benign from malignant masses with an overall accuracy of 91%[90]. DWI is also found to have a diagnostic value in evaluating patients with multiple myeloma.…”