الفهرس | Only 14 pages are availabe for public view |
Abstract Background: MRI is a diagnostic mainstay for detection and differentiation of bone tumors. However, a projection regarding the biological dignity of lesions is based on standard MRI sequences remains difficult and uncertain. This study was undertaken to analyze whether diffusion weighted MRI (DWI) can distinguish between benign & malignant bone tumors. Aim of the Work: To evaluate the diagnostic performance of quantitative parameters derived from diffusion–weighted imaging (DWI) in differentiating benign and malignant bone tumors. Patients and Methods: This study was conducted on 32 patients, with no age predilection, at the MRI unit of the Radiology Department Ain Shams university, outpatient clinics and private centers using high field device at least 1.5 Tesla MRI Device after getting approval from each ethical committee. The patients were referred to MRI unit from orthopedic surgery and radiotherapy departments and oncology center. Results: Our study was carried out on 32 patients were diagnosed with bone tumors (21 benign & 11 malignant). They were assessed with conventional & diffusion MR images, DW EPI carried out using different b values including 0 s/ mm², 500 s/ mm², and 800 s/ mm². ADC map were automatically calculated. The mean ADC value for benign tumors was 1.6±0.4 x 10 -3 mm2/s. while malignant tumors were 1.2±0.3 x 10 -3 mm2/s. ROC analysis was used to define the best cut off mean ADC value for detecting malignancy which was <1.3, with sensitivity of 90.9% specificity of 85.7%. Conclusion: The present study showed high specificity and sensitivity of DWI as a complementary sequence with conventional MRI and ADC value measurements in discrimination between benign and malignant bone tumors with significant cut-off value, making it a noninvasive tool for increasing the accuracy in identifying bone lesions. However, further studies with larger patient groups are needed to find an optimal cut‑off ADC value for differentiation between begin and malignant bone tumors. Recommendations: it’s recommended to add DWI as a complementary sequence to conventional MRI as a non-invasive tool for increasing the accuracy in identification of bone lesions. |