Is there a role for diffusion-weighted MRI (DWI) in the diagnosis of central cartilage tumors?

• Published in: Skeletal radiology Vol. 44; no. 7; pp. 963 - 969
• Main Authors: Douis, H., Jeys, L., Grimer, R., Vaiyapuri, S., Davies, A. M.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-07-2015; Springer; Springer Nature B.V
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Bone Neoplasms - pathology; Child; Chondroma - pathology; Chondrosarcoma - pathology; Diagnosis; Diagnosis, Differential; Diffusion Magnetic Resonance Imaging - methods; Drunk driving; Female; Humans; Image Interpretation, Computer-Assisted - methods; Imaging; Magnetic resonance imaging; Male; Medicine; Medicine & Public Health; Middle Aged; Nuclear Medicine; Observer Variation; Orthopedics; Pathology; Radiology; Reproducibility of Results; Scientific Article; Sensitivity and Specificity; Tumors; Young Adult; Chondrosarcoma; MR imaging; Enchondroma; Diffusion-weighted MRI
• ISSN: 0364-2348; 1432-2161
• DOI: 10.1007/s00256-015-2123-7

Objective
To assess if diffusion-weighted MRI (DWI) can differentiate between central enchondromas and chondrosarcomas (CS) and if DWI can distinguish low-grade chondroid lesions from high-grade CS.
Materials and methods
Fifty-two patients with central cartilage tumors were included. Patients underwent conventional MRI and DWI with ADC mapping. The slice on MRI with the most aggressive imaging feature was identified. The corresponding mean and minimum ADC maps of the tumor at this position were measured.
Results
There were 24 enchondromas, five atypical cartilaginous lesions, 15 grade 1, three grade 2, two grade 3, and three dedifferentiated CS. Mean ADC values (×10
−6
 mm
2
/s) for enchondromas, atypical cartilaginous tumors, grade 1 CS, grade 2, CS, grade 3 CS and dedifferentiated CS were 1,896, 2,048, 2,152, 2,170, 2,076, and 1,261, respectively. Minimum ADC values (×10
−6
 mm
2
/s) for enchondromas, atypical cartilaginous tumors, grade 1 CS, grade 2, CS, grade 3 CS and dedifferentiated CS were 1,820, 1,752, 2,010, 1,829, 1,752, and 767, respectively. ANOVA test demonstrated a statistically significant difference in mean and minimum ADC values in all groups. Post hoc analysis revealed this was due to difference in mean and minimum ADC values in dedifferentiated CS. The mean ADC value in low-grade chondroid lesions was 2,001, while the ADC value for high-grade CS were 2,132. The minimum ADC value for low-grade chondroid lesions was 1,896, while the minimum ADC for high-grade CS was 1,837. The difference in minimum and mean ADC values was not statistically significant.
Conclusions
DWI cannot differentiate between enchondromas and CS and DWI does not aid in the distinction of low-grade chondroid tumors from high-grade CS.