Magnetic Resonance Diffusion Tensor Imaging in Differentiating Benign and Malignant Compressed Vertebrae

Abstract

Background: There are several causes of vertebral compression fractures (VCFs), including neoplastic infiltration, osteoporosis, and trauma. Our objective was to examine the diagnostic accuracy of magnetic resonance diffusion tensor imaging (MR-DTI) in differentiating benign from malignant compressed vertebrae. This prospective research was carried out on a selected group of 30 cases with compressed vertebral fracture diagnosed by other imaging modalities and a control group of 30 subjects referred to MR unit of Radiodiagnosis Department at the Local University Hospitals. Inclusion criteria were adult patients, both sexes, Patients with compressed vertebral fracture diagnosed by other imaging modalities. Results: According to ROC analysis for detecting specificity and sensitivity of fractional anisotropy (FA), apparent diffusion coefficient (ADC) and mean diffusivity quantitative analysis of DTI MRI to differentiate between malignant and benign VCFs in cases group, we can see that the ROC for FA gives AUC 0.886  while ADC gives AUC 0.886 and MD gives AUC 0.922, with specificity and sensitivity of FA 85.71% and 93.75% respectively, while specificity and sensitivity of ADC 92.86% and 87.50%  respectively and specificity and sensitivity of MD  92.86% and 87.50%  respectively. Conclusions: DTI with its quantitative indicators is a valuable method in differentiating malignant from benign compressed vertebrae when compared to conventional MRI. FA values in benign vertebral fracture were significantly less than the FA values in malignant vertebral fracture.