Diagnostic accuracy of diffusion tensor imaging in differentiating malignant from benign compressed vertebrae

• Published in: Neuroradiology Vol. 61; no. 11; pp. 1291 - 1296
• Main Authors: Razek, Ahmed Abdel Khalek Abdel, Sherif, Fatma Mohamed
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-11-2019; Springer Nature B.V
• Subjects: Accuracy; Adult; Aged; Anisotropy; Benign; Diagnosis, Differential; Diagnostic systems; Diffusion Tensor Imaging - methods; Female; Humans; Imaging; Magnetic resonance; Magnetic resonance imaging; Male; Mathematical analysis; Medical diagnosis; Medical imaging; Medicine; Medicine & Public Health; Middle Aged; Neurology; Neuroradiology; Neurosciences; Neurosurgery; Radiology; Readers; Spinal Diseases - diagnostic imaging; Spinal Neoplasms - diagnostic imaging; Spinal Neuroradiology; Spine; Tensors; Vertebrae; Spinal; Compression; Tensor; MR imaging; Diffusion
• ISSN: 0028-3940; 1432-1920
• DOI: 10.1007/s00234-019-02286-x

Purpose
To study diagnostic accuracy of diffusion tensor imaging (DTI) in differentiating malignant from benign compressed vertebrae.
Methods
This study was done on 43 patients with compressed vertebrae on conventional magnetic resonance study that underwent DTI. The mean diffusivity (MD) and fractional anisotropy (FA) of malignant (
n
 = 24) and benign (
n
 = 19) compressed vertebrae were calculated by two readers.
Results
There was a significantly lower (
P
 = 0.001) MD of both readers between malignant (0.74 ± 0.2 and 0.78 ± 0.2 × 10
−3
 mm
2
/s) and benign (1.67 
+
 0.3 and 1.63 ± 0.3 × 10
−3
 mm
2
/s) compressed vertebrae. The FA of malignant compressed vertebrae of both readers (0.55 ± 0.2 and 0.52 ± 0.1) was significantly higher (
P
 = 0.001) than that of benign (0.26 ± 0.1 and 0.28 ± 0.1) compressed vertebrae. There was excellent inter-reader agreement between both readers using MD (
K
 = 0.91) and FA (
K
 = 0.86). The thresholds of MD and FA used for differentiating malignant from benign compressed vertebrae of both readers were 1.15 and 1.16 × 10
−3
 mm
2
/s and 0.37 and 0.34 with area under the curve (AUC) of 0.98, 0.96, 0.93, and 0.92 and diagnostic accuracy of 95.3%, 88.4%, 90.1%, and 86.0% respectively. Combined MD and FA revealed AUC of 0.99 and 0.97 and diagnostic accuracy of 95.3% and 93.0% by both readers respectively.
Conclusion
DTI is a non-invasive technique providing accurate imaging parameters that can be used for differentiating malignant from benign compressed vertebrae.