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

Area of Science:

• Radiology
• Medical Imaging
• Oncology

Background:

• Compressed vertebrae can be challenging to diagnose as malignant or benign using conventional MRI.
• Accurate differentiation is crucial for appropriate patient management and treatment planning.

Purpose of the Study:

• To evaluate the diagnostic accuracy of diffusion tensor imaging (DTI) in distinguishing malignant from benign compressed vertebrae.
• To assess the utility of DTI-derived parameters, mean diffusivity (MD) and fractional anisotropy (FA), in this differentiation.

Main Methods:

• 43 patients with compressed vertebrae underwent DTI after conventional MRI.
• Mean diffusivity (MD) and fractional anisotropy (FA) values were calculated for malignant (n=24) and benign (n=19) compressed vertebrae by two independent readers.
• Inter-reader agreement was assessed using Cohen's kappa coefficient.

Main Results:

• Significantly lower MD (P<0.001) and significantly higher FA (P<0.001) were observed in malignant compared to benign compressed vertebrae for both readers.
• Excellent inter-reader agreement was found for both MD (K=0.91) and FA (K=0.86).
• Combined MD and FA achieved high diagnostic accuracy (up to 95.3%) and area under the curve (AUC) (up to 0.99) in differentiating lesion types.

Conclusions:

• Diffusion tensor imaging (DTI) is a valuable non-invasive tool for differentiating malignant from benign compressed vertebrae.
• DTI-derived parameters, MD and FA, provide accurate imaging biomarkers for lesion characterization.
• The findings support the integration of DTI into the diagnostic workup of compressed vertebrae.