Hyun Kyong Lim MD, Presenter: Nothing to Disclose

Won-Hee Jee MD, Abstract Co-Author: Nothing to Disclose

Joon-Yong Jung MD, Abstract Co-Author: Nothing to Disclose

Mun-Young Paek, Abstract Co-Author: Employee, Siemens AG

Robert Grimm, Abstract Co-Author: Employee, Siemens AG

Yang-Guk Chung MD, Abstract Co-Author: Nothing to Disclose

To retrospectively evaluate the intravoxel incoherent motion (IVIM)-derived parameters for differentiating between benign and malignant musculoskeletal tumor at 3.0T diffusion-weighted magnetic resonance (DW) imaging.

The institutional review board approved this HIPAA-compliant study, and informed consent was waived. Sixty-three patients with treatment-naïve musculoskeletal tumors who underwent MR imaging including IVIM DW imaging were included in this study: 47 malignant and 20 benign lesions. IVIM DW imaging was obtained with nine b values (0800 sec/mm2) at 3.0T. IVIM-derived parameters included pure diffusion coefficient, perfusion related incoherent microcirculation (pseudodiffusion coefficient), and perfusion fraction. IVIM related parameters were retrospectively measured within the solid portion based on standard MR images by two independent musculoskeletal radiologists. Intraclass correlation coefficient (ICC) was used for interobserver reliability test. Mann-Whitney U test and two sample t-test were performed for comparison. The diagnostic performance of the parameters was evaluated by using receiver operating characteristic (ROC) analysis.

The pure diffusion coefficient of malignant tumors (920 ±360 μm2/sec) were significantly lower than those of benign tumors (1540 ±660 μm2/sec) (P<.001). The perfusion fraction of malignant tumors (9.56%) were significantly higher than those of benign tumors (6.80%) (P=.011). The pseudodiffusion coefficient showed no significant difference (P >.05). The area under the ROC curve of pure diffusion coefficient and perfusion fraction were 0.80 and 0.70, respectively (P<.01). Using cut-off values of pure diffusion coefficient of 1160 μm2/sec, the sensitivity and specificity were 90% and 75%, respectively. The ICC value showed good to excellent interobserver agreement between two readers (0.98 for pure diffusion coefficient; 0.70 for pseudodiffusion coefficient; 0.80 for perfusion fraction).

IVIM-derived pure diffusion coefficient and perfusion fraction were more valuable parameters in the differentiation of malignant from benign musculoskeletal tumors than pseudodiffusion coefficient at 3.0T IVIM DW imaging.

IVIM-derived pure diffusion coefficient and perfusion fraction were more valuable parameters in the differentiation of malignant from benign musculoskeletal tumors than pseudodiffusion coefficient at 3.0T IVIM DW imaging

Lim, H, Jee, W, Jung, J, Paek, M, Grimm, R, Chung, Y, Intravoxel Incoherent Motion Diffusion-weighted MR Imaging for Characterization of Musculoskeletal Tumors at 3.0T.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045433.html