title: Differentiating benign from malignant vertebral fractures using T1 -weighted dynamic contrast-enhanced MRI.
abstract: OBJECTIVE
  To differentiate pathologic from benign vertebral fractures, which can be challenging. We hypothesized that dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) can aid in the noninvasive distinction between pathologic and benign fractures.
  
  
  METHODS
  Consecutive patients with vertebral fractures who underwent DCE-MRI, biopsy, and kyphoplasty were reviewed. Forty-seven fractures were separated into pathologic and benign fractures. Benign fractures were in turn separated into acute and chronic fractures for further comparison. Regions of interest (ROIs) were placed over fractured vertebral bodies. Perfusion parameters: plasma volume (Vp ), K(trans) , wash-in slope, peak enhancement, and area under the curve (AUC) were measured and compared between the three different groups of fractures. A Mann-Whitney U-test was conducted to assess the difference between the groups.
  
  
  RESULTS
  Pathologic fractures had significantly higher (P < 0.01) perfusion parameters (Vp , K(trans) , wash-in slope, peak enhancement, and AUC) compared with benign fractures. We also found significant differences (P < 0.001) in all parameters between chronic and acute fractures. Vp and K(trans) were able to differentiate between pathologic and acute fractures (P < 0.01). No significant differences were found with peak enhancement (P = 0.21) and AUC (P = 0.4) between pathologic and acute fractures.
  
  
  CONCLUSIONS
  Our data demonstrate that T1 -weighted DCE-MRI has potential to differentiate between pathologic vs. benign, acute vs. chronic, and most important, benign acute vs. pathologic vertebral fractures.
authors: Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
authors: Julio
authors: J
authors: Arevalo-Perez
authors: Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.|Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
authors: Kyung K
authors: KK
authors: Peck
authors: Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
authors: John K
authors: JK
authors: Lyo
authors: Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
authors: Andrei I
authors: AI
authors: Holodny
authors: Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
authors: Eric
authors: E
authors: Lis
authors: Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
authors: Sasan
authors: S
authors: Karimi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016103:Spinal Fractures / Q000209:etiology* / Q000473:pathology*; D013125:Spinal Neoplasms / Q000150:complications* / Q000473:pathology*
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA
keywords: benign vs. acute; differentiate; vertebral compression fractures
references: Cancer. 1996 Oct 1;78(7):1388-94
references: 8839543
references: Eur J Radiol. 2010 Dec;76(3):298-303
references: 20580503
references: J Magn Reson Imaging. 1996 Mar-Apr;6(2):311-21
references: 9132096
references: AJR Am J Roentgenol. 1996 Oct;167(4):1029-36
references: 8819407
references: Cancer. 1997 Oct 15;80(8 Suppl):1557-63
references: 9362422
references: Med Oncol Tumor Pharmacother. 1991;8(4):253-60
references: 1820491
references: J Magn Reson Imaging. 1999 Sep;10(3):223-32
references: 10508281
references: J Magn Reson Imaging. 1999 Sep;10(3):286-94
references: 10508288
references: AJR Am J Roentgenol. 2013 Jun;200(6):W635-43
references: 23701095
references: Radiology. 1998 Sep;208(3):821-8
references: 9722866
references: Spine (Phila Pa 1976). 2013 Oct 15;38(22):E1418-24
references: 23873238
references: J Magn Reson Imaging. 2002 Mar;15(3):308-14
references: 11891976
references: AJNR Am J Neuroradiol. 2012 Dec;33(11):2178-85
references: 22555585
references: Skeletal Radiol. 2005 Oct;34(10):632-8
references: 16091963
references: Radiology. 1998 May;207 (2):349-56
references: 9577479
references: Radiographics. 2003 Jan-Feb;23(1):179-87
references: 12533652
references: Radiology. 2014 May;271(2):488-98
references: 24484060
references: Radiol Clin North Am. 1990 Mar;28(2):471-83
references: 2408106
references: Ann Oncol. 2003 Jan;14(1):152-8
references: 12488307
references: Phys Ther. 1999 Feb;79(2):196-201
references: 10029059