Objectives To evaluate the diagnostic performance of proton density fat fraction (PDFF) magnetic resonance imaging (MRI) to differentiate between acute benign and neoplastic vertebral compression fractures (VCFs). Methods Fifty-seven consecutive patients with 46 acute benign and 41 malignant VCFs were prospectively enrolled in this institutional review board approved study and underwent routine clinical MRI with an additional six-echo modified Dixon sequence of the spine at a clinical 3.0-T scanner. All fractures were categorised as benign or malignant according to either direct bone biopsy or 6-month follow-up MRI. Intravertebral PDFF and PDFF (fracture PDFF/normal vertebrae PDFF) for benign ratio and malignant VCFs were calculated using region-of-interest analysis and compared between both groups. Additional receiver operating characteristic and binary logistic regression analyses were performed. Results Both PDFF and PDFF of malignant VCFs were significantly lower compared to acute benign VCFs [PDFF, 3.48 ± ratio 3.30% vs 23.99 ± 11.86% (p <0.001); PDFF , 0.09 ± 0.09 vs 0.49 ± 0.24 (p < 0.001)]. The areas under the curve were 0.98 for ratio PDFF and 0.97 for PDFF , yielding an accuracy of 96% and 95% for differentiating between acute benign and malignant ratio VCFs. PDFF remained as the only imaging-based variable
European Radiology – Springer Journals
Published: Jun 1, 2018
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