Multiparametric approach with diffusion-weighted imaging and dynamic contrast-enhanced MRI: a comparison study for differentiating between benign and malignant bone lesions in adults.
OBJECTIVE
To evaluate and compare the diagnostic performance of quantitative parameters derived from diffusion-weighted imaging (DWI) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in differentiating benign and malignant bone tumours.


METHODS
Fifty-five patients (age range, 21-82 years; mean age, 55 years) underwent pretreatment MRI. Apparent diffusion coefficient (ADC) values were calculated by DWI. The DCE-MRI data were analysed for the volume transfer constant (Ktrans), extravascular extracellular volume fraction (Ve), and volume rate constant (Kep), and Ktrans/ADC ratio. Each parameter's performance was evaluated using the area under the receiver operating characteristic (ROC) curv (AUC), and their AUCs were compared. ROC curves were analysed and each parameter's optimal cut-off value was determined, from which each parameter was evaluated for sensitivity, specificity, accuracy, and positive and negative predictive values. The odds ratio (OR) with 95% confidence interval for detecting malignant bone lesions after adjusting the age factor of each parameter was estimated.


RESULTS
All parameter values (except Ve) were significantly different between benign and malignant bone tumours (p<0.05). The Ktranshad a significantly greater AUC than Ve(p=0.03). The Ktrans/ADC and Kephad the best sensitivity (0.917) and specificity (0.632), respectively. The Kepand Ktrans/ADC had the best positive (0.811) and negative (0.769) predictive values, respectively. The OR was highest for Ktrans/ADC (17.38; p=0.0013).


CONCLUSIONS
The Ktrans, Kep, ADC, and Ktrans/ADC could help to detect malignant lesions from bone tumours and Ktrans/ADC appears to be the superior variable among them.
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea.
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E
Oh
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea. Electronic address: ycyoon@skku.edu.
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YC
Yoon
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
J H
JH
Kim
Department of Biostatistics and Clinical Epidemiology, Samsung Medical Center, Seoul, Republic of Korea.
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K
Kim
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001847:Bone Diseases / Q000000981:diagnostic imaging*; D001859:Bone Neoplasms / Q000000981:diagnostic imaging*; D003287:Contrast Media; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D055815:Young Adult
D003287:Contrast Media