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Detection of Osseous Spinal Metastasis with T1-Weighted Dynamic Contrast-Enhanced MRI and 18F-FDG PET/CT: Assessing
Deeptha Bejugam1,2, Kyung K Peck1,3, Atin Saha1
1From the Department of Radiology (D.B., K.K.P., A.S., E.Y.-C., O.Y., J.A.-P., S. Krebs, E.L., S. Karimi, A.I.H.), Memorial Sloan Kettering Cancer Center, New York, New York.
Background And Purpose:
18F-FDG PET/CT and conventional MRI are common first-line imaging modalities for assessment of osseous spinal lesions. Dynamic contrast-enhanced MR imaging (DCE-MRI) is an advanced technique that quantifies vascular perfusion parameters like vessel permeability (Ktrans ) and plasma volume (Vp ), which are markers of viable tumor. Although DCE-MRI and 18F-FDG PET/CT are individually recognized for tumor detection, comparisons between Vp and PET-obtained maximum standardized uptake value (SUVmax) have not been performed. This study evaluates the concordance between Vp and SUVmax in detecting pathologically confirmed, nontreated osseous spinal metastases.
Materials And Methods:
Nontreated osseous spinal metastases biopsy-confirmed between February 2015 and January 2022 with available DCE-MRI and 18F-FDG PET/CT scans were retrospectively analyzed. Exclusion criteria included radiation therapy near lesions and therapy between scans. Mean Ktrans and Vp were obtained from DCE-MRI via the extended Tofts model and compared with PET SUVmax values. A Vp threshold of 2.10 and PET SUVmax thresholds of 2.00, 2.50, and 4.00 were used to detect metastases. Agreement was assessed via McNemar tests (α = .05).
Results:
Eighty-five metastases across 69 patients (mean age: 64.15 [SD, 12.13] years; 35 men) were evaluated. At an SUVmax threshold of 2.00, Vp demonstrated a high agreement of 81.18% (69/85) with SUVmax in detecting biopsy-confirmed tumors. Agreement with other SUVmax thresholds was lower: 67.06% (57/85) for an SUVmax of 2.50 and 48.24% (41/85) for an SUVmax of 4.00, as expected. Vp identified the most metastases at 84, compared with 68, 56, and 40 for SUVmax thresholds of 2.00, 2.50, and 4.00, respectively (P < .001).
Conclusions:
Vp and SUVmax showed agreement in detecting osseous spinal metastases. However, when common thresholds for these metrics are applied, Vp exceeds SUVmax in identifying viable tumor. DCE-MRI plays a crucial role in detecting spinal metastases and, in some instances, more accurately detects biopsy-positive lesions compared with 18F-FDG PET/CT.
Insights
Dynamic contrast-enhanced MRI's plasma volume (Vp) shows good agreement with 18F-FDG PET/CT's SUVmax for detecting spinal metastases. Vp identifies more viable tumors than SUVmax at common thresholds, enhancing diagnostic capabilities.
Area of Science:
- Oncology
- Radiology
- Medical Imaging
Background:
- 18F-FDG PET/CT and MRI are standard for spinal lesions.
- Dynamic contrast-enhanced MRI (DCE-MRI) quantifies tumor markers like plasma volume (Vp).
- No prior studies compared Vp from DCE-MRI with SUVmax from 18F-FDG PET/CT.
Purpose of the Study:
- To evaluate the concordance between Vp and SUVmax in detecting osseous spinal metastases.
- To compare the diagnostic performance of Vp and SUVmax in identifying viable tumor.
- To assess the role of DCE-MRI in spinal metastasis detection.
Main Methods:
- Retrospective analysis of biopsy-confirmed, non-treated osseous spinal metastases with available DCE-MRI and 18F-FDG PET/CT scans.
- Quantification of mean Vp from DCE-MRI using the extended Tofts model.
- Comparison of Vp values with 18F-FDG PET/CT SUVmax values using McNemar's tests.
Main Results:
- Eighty-five metastases in 69 patients were analyzed.
- Vp showed 81.18% agreement with SUVmax (threshold 2.00) in detecting tumors.
- Vp identified significantly more metastases (84) than SUVmax at various thresholds (p < 0.001).
Conclusions:
- Vp and SUVmax demonstrate agreement in detecting osseous spinal metastases.
- Vp surpasses SUVmax in identifying viable tumor when common thresholds are applied.
- DCE-MRI provides valuable quantitative data that complements 18F-FDG PET/CT for spinal metastasis diagnosis.
![Visualization and Quantification of Brown and Beige Adipose Tissues in Mice using [18F]FDG Micro-PET/MR Imaging](/_next/image?url=https%3A%2F%2Fcloudfront.jove.com%2FCDNSource%2Fteasers%2F62460.jpg&w=3840&q=50)
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