Diagnosis of spinal lesions using perfusion parameters measured by DCE-MRI and metabolism parameters measured by PET/CT
To investigate the correlation of parameters measured by dynamic-contrast-enhanced MRI (DCE-MRI) and 18F-FDG PET/CT in spinal tumors, and their role in differential diagnosis.
A total of 49 patients with pathologically confirmed spinal tumors, including 38 malignant, six benign and five borderline tumors, were analyzed. The MRI and PET/CT were done within 3 days, before biopsy. On MRI, the ROI was manually placed on area showing the strongest enhancement to measure pharmacokinetic parameters Ktrans and kep. On PET, the maximum standardized uptake value SUVmax was measured. The parameters in different histological groups were compared. ROC was performed to differentiate between the two largest subtypes, metastases and plasmacytomas. Spearman rank correlation was performed to compare DCE-MRI and PET/CT parameters.
The Ktrans, kep and SUVmax were not statistically different among malignant, benign and borderline groups (P = 0.95, 0.50, 0.11). There was no significant correlation between Ktrans and SUVmax (r = − 0.20, P = 0.18), or between kep and SUVmax (r = − 0.16, P = 0.28). The kep was significantly higher in plasmacytoma than in metastasis (0.78 ± 0.17 vs. 0.61 ± 0.18, P = 0.02); in contrast, the SUVmax was significantly lower in plasmacytoma than in metastasis (5.58 ± 2.16 vs. 9.37 ± 4.26, P = 0.03). In differential diagnosis, the AUC of kep and SUVmax was 0.79 and 0.78, respectively.
The vascular parameters measured by DCE-MRI and glucose metabolism measured by PET/CT from the most aggressive tumor area did not show a significant correlation. The results suggest they provide complementary information reflecting different aspects of the tumor, which may aid in diagnosis of spinal lesions.
KeywordsMagnetic resonance imaging Positron emission tomography/computed tomography Spinal neoplasms
Area under the curve
Dynamic-contrast-enhanced magnetic resonance imaging
Positron emission tomography
Receiver operating characteristic
Region of interest
Standardized uptake value
This study was supported by National Natural Science Foundation of China (81701648 and 81971578), NIH R01 CA127927 and Key Clinical Projects of the Peking University Third Hospital (BYSY2018007).
Compliance with ethical standards
Conflict of interest
None of the authors has any potential conflict of interest.
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