Differentiation between benign and malignant vertebral compression fractures using qualitative and quantitative analysis of a single fast spin echo T2-weighted Dixon sequence.

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State: Public
Version: author
License: CC BY 4.0
Serval ID
serval:BIB_863B8DD3F22C
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Differentiation between benign and malignant vertebral compression fractures using qualitative and quantitative analysis of a single fast spin echo T2-weighted Dixon sequence.
Journal
European radiology
Author(s)
Bacher S., Hajdu S.D., Maeder Y., Dunet V., Hilbert T., Omoumi P.
ISSN
1432-1084 (Electronic)
ISSN-L
0938-7994
Publication state
Published
Issued date
12/2021
Peer-reviewed
Oui
Volume
31
Number
12
Pages
9418-9427
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
To determine and compare the qualitative and quantitative diagnostic performance of a single sagittal fast spin echo (FSE) T2-weighted Dixon sequence in differentiating benign and malignant vertebral compression fractures (VCF), using multiple readers and different quantitative methods.
From July 2014 to June 2020, 95 consecutive patients with spine MRI performed prior to cementoplasty for acute VCFs were retrospectively included. VCFs were categorized as benign (n = 63, mean age = 76 ± 12 years) or malignant (n = 32, mean age = 63 ± 12 years) with a best valuable comparator as a reference. Qualitative analysis was independently performed by four radiologists by categorizing each VCF as either benign or malignant using only the image sets provided by FSE T2-weighted Dixon sequences. Quantitative analysis was performed using two different regions of interest (ROI1-2) and three methods (signal drop, fat fraction (FF) from ROIs, FF maps). Diagnostic performance was compared using ROC curves analyses. Interobserver agreement was assessed using kappa statistics and intraclass correlation coefficients (ICC).
The qualitative diagnostic performance ranged from area under the curve (AUC) = 0.97 (95% CI: 0.91-1.00) to AUC = 0.99 (95% CI: 0.95-1.0). The quantitative diagnostic performance ranged from AUC = 0.82 (95% CI: 0.73-0.89) to AUC = 0.97 (95% CI: 0.91-0.99). Pairwise comparisons showed no statistical difference in diagnostic performance (all p > 0.0013, Bonferroni-corrected p < 0.0011). All five cases with disagreement among the readers were correctly diagnosed at quantitative analysis using ROI2. Interobserver agreement was excellent for both qualitative and quantitative analyses.
A single FSE T2-weighted Dixon sequence can be used to differentiate benign and malignant VCF with high diagnostic performance using both qualitative and quantitative analyses, which can provide complementary information.
• Qualitative analysis of a single FSE T2-weighted Dixon sequence yields high diagnostic performance and excellent observer agreement for differentiating benign and malignant compression fractures. • The same FSE T2-weighted Dixon sequence allows quantitative assessment with high diagnostic performance. • Quantitative data can readily be extracted from the FSE T2-weighted Dixon sequence and may provide complementary information to the qualitative analysis, which may be useful in doubtful cases.
Keywords
Aged, Aged, 80 and over, Fractures, Compression/diagnostic imaging, Humans, Magnetic Resonance Imaging, Middle Aged, ROC Curve, Retrospective Studies, Spinal Fractures/diagnostic imaging, Bone marrow, Compression fractures, Diagnostic imaging, Magnetic resonance imaging, Spinal fractures
Pubmed
Web of science
Open Access
Yes
Create date
11/06/2021 17:07
Last modification date
05/12/2021 6:38
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