Diffusion-weighted imaging for predicting new compression fractures following percutaneous vertebroplasty

Area of Science:

• Radiology
• Orthopedic Surgery
• Medical Imaging

Background:

• Percutaneous vertebroplasty (PVP) is a procedure to stabilize fractured vertebrae.
• Recurrent back pain post-PVP can stem from new compression fractures in adjacent vertebral bodies.

Purpose of the Study:

• To determine if apparent diffusion coefficient (ADC) of adjacent vertebrae, measured by diffusion-weighted imaging (DWI) before PVP, can predict new compression fractures.
• Investigate the predictive value of preoperative ADC for post-PVP fracture development.

Main Methods:

• A study involving 25 patients undergoing PVP for osteoporotic compression fractures.
• ADC measurements were taken on 49 adjacent vertebral bodies (above and below the treated site) before and after PVP.
• Comparison of ADC values between vertebral bodies that developed new fractures within one month and those that did not.

Main Results:

• Vertebral bodies that developed new fractures showed significantly higher mean preoperative ADC (0.55 x 10(-3) mm(2)/s) compared to those without new fractures (0.20 x 10(-3) mm(2)/s) (P < 0.001).
• Patients who developed new fractures had a higher mean preoperative ADC (0.55 x 10(-3) mm(2)/s) than those who did not (0.17 x 10(-3) mm(2)/s) (P < 0.001).

Conclusions:

• Preoperative apparent diffusion coefficient (ADC) of adjacent vertebral bodies may serve as a predictor for new compression fractures after PVP.
• Diffusion-weighted imaging (DWI) assessed ADC could help identify patients at higher risk for post-PVP fractures.