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Diagnostic Approach and Differences between Spinal Infections and Tumors.

Domenico Compagnone1, Riccardo Cecchinato1, Andrea Pezzi1,2

  • 1IRCCS Ospedale Galeazzi-Sant'Ambrogio, 20157 Milan, Italy.

Diagnostics (Basel, Switzerland)
|September 9, 2023
PubMed
Summary
This summary is machine-generated.

Differentiating spine infections from bone tumors is challenging due to geographic variations. This review evaluates imaging techniques to aid in diagnosing spinal infections versus tumors, guiding biopsy decisions.

Keywords:
radiological diagnosticradiological differential diagnosisspine bone tumorspine infection

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Area of Science:

  • Radiology
  • Oncology
  • Infectious Diseases

Background:

  • Differential diagnosis between spine infection and bone tumors is complicated by varying prevalence worldwide.
  • Imaging findings can suggest diagnoses, aiding in biopsy site selection.
  • Reliable imaging techniques are crucial for accurate diagnosis.

Purpose of the Study:

  • To identify the most reliable imaging technique for differentiating spine infections from bone tumors.
  • To review imaging characteristics of various spinal pathologies.

Main Methods:

  • Systematic literature review of Medline database.
  • Identified and analyzed five main groups: tuberculous, atypical spinal tuberculosis, pyogenic spondylitis, and neoplastic (primitive and metastatic).
  • Evaluated imaging features across CT, CT perfusion, MRI, MRI with Gadolinium, and MRI diffusion (DWI) for each group.

Main Results:

  • A total of 22 full-text articles were assessed after initial screening of 602 studies.
  • Data on the role of CT-scan, CT-perfusion, MRI, MRI with Gadolinium, and MRI diffusion (DWI) were collected.
  • Key imaging features for distinguishing spine infection from bone tumor/metastasis were identified.

Conclusions:

  • Definitive diagnosis requires biopsy and culture.
  • Percutaneous biopsy demonstrates high sensitivity (72%) and specificity (94%).
  • Imaging is supplementary; multidisciplinary discussion with radiologists and nuclear medicine specialists is mandatory.