Role of diffusion-weighted MRI in differentiating between benign and malignant bone lesions: a prospective study

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Distinguishing benign from malignant bone tumors is crucial for appropriate patient management.
• Diffusion-weighted magnetic resonance imaging (DW-MRI) offers potential for non-invasive tissue characterization.

Purpose of the Study:

• To evaluate the diagnostic capability of DW-MRI in differentiating benign and malignant bony tumors.
• To determine the effectiveness of apparent diffusion coefficient (ADC) values in this differentiation.

Main Methods:

• Prospective study of 62 patients with suspected bony lesions.
• Inclusion of clinical examination, radiography, CT, ultrasonography, and 1.5-T MRI.
• Post-processing analysis using a Philips Extended MRI workspace workstation.

Main Results:

• Benign lesions showed ADC values ranging from 0.85-2.44 × 10^-3 mm²/s.
• Malignant lesions exhibited ADC values between 0.42-2.4 × 10^-3 mm²/s, with metastatic lesions averaging 0.71 × 10^-3 mm²/s.
• Significant differences were observed in mean, minimum, and maximum ADC values between benign and malignant tumors.

Conclusions:

• DW-MRI, specifically ADC values, can effectively differentiate benign from malignant bone tumors.
• An optimal ADC cut-off range of 0.78-0.86 × 10^-3 mm²/s demonstrated high sensitivity (89.47%), specificity (97.22%), and accuracy (94.55%) for predicting malignancy.