Diagnostic accuracy of diffusion tensor imaging in differentiating malignant from benign compressed vertebrae

  • Ahmed Abdel Khalek Abdel RazekEmail author
  • Fatma Mohamed Sherif
Spinal Neuroradiology



To study diagnostic accuracy of diffusion tensor imaging (DTI) in differentiating malignant from benign compressed vertebrae.


This study was done on 43 patients with compressed vertebrae on conventional magnetic resonance study that underwent DTI. The mean diffusivity (MD) and fractional anisotropy (FA) of malignant (n = 24) and benign (n = 19) compressed vertebrae were calculated by two readers.


There was a significantly lower (P = 0.001) MD of both readers between malignant (0.74 ± 0.2 and 0.78 ± 0.2 × 10−3 mm2/s) and benign (1.67 + 0.3 and 1.63 ± 0.3 × 10−3 mm2/s) compressed vertebrae. The FA of malignant compressed vertebrae of both readers (0.55 ± 0.2 and 0.52 ± 0.1) was significantly higher (P = 0.001) than that of benign (0.26 ± 0.1 and 0.28 ± 0.1) compressed vertebrae. There was excellent inter-reader agreement between both readers using MD (K = 0.91) and FA (K = 0.86). The thresholds of MD and FA used for differentiating malignant from benign compressed vertebrae of both readers were 1.15 and 1.16 × 10−3 mm2/s and 0.37 and 0.34 with area under the curve (AUC) of 0.98, 0.96, 0.93, and 0.92 and diagnostic accuracy of 95.3%, 88.4%, 90.1%, and 86.0% respectively. Combined MD and FA revealed AUC of 0.99 and 0.97 and diagnostic accuracy of 95.3% and 93.0% by both readers respectively.


DTI is a non-invasive technique providing accurate imaging parameters that can be used for differentiating malignant from benign compressed vertebrae.


Diffusion Tensor MR imaging Spinal Compression 



Apparent diffusion coefficient


Diffusion tensor imaging


Diffusion-weighted imaging


Mean diffusivity


Fractional anisotropy


Region of interest


Author contribution

A Abdel Razek: idea, MR analysis, writing manuscript and statistical analysis

F Elsherif: data collection, image analysis, and statistical analysis

Funding information

No funding was received for this study.

Compliance with ethical standards

Conflict of interest

All authors declare they have no conflict of interest.

Ethical approval

All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Waived because this is a retrospective study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Diagnostic RadiologyMansoura Faculty of MedicineMansouraEgypt

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