Value of diffusion weighted MRI in differentiating benign from malignant bony tumors and tumor like lesions

Abstract

Aim of the work: To assess the value of diffusion weighted MRI in the differentiation of benign and malignant bony tumors and tumor like lesions. Patients and methods: This study included 100 patients (66 males and 34 females). Their ages ranged between 4 and 65 years and the mean age was 31.3 years. The patients were referred to MRI unit from orthopedic surgery and radiotherapy departments and oncology center in Mansoura University hospital. These patients were selected on clinical bases indicating or suggesting presence of bony tumors or tumor-like lesions as a primary diagnosis (e.g. swelling or signs of inflammation). The commonest clinical presentations were pain (n = 71) and swelling (n = 61). Other presentations included limitation of movement (n = 20), back pain (n = 21) and fever (n = 20). More than one symptom may be present in one patient. Patients included in our study were classified according to the pathological and radiological criteria into three groups: Benign bone tumors (14 patients); malignant bone tumors (51 patients); tumor-like lesions (35 patients). Results: DWI with measurement of ADC values helped in the differentiation of benign and malignant bone tumors, as malignant bone tumors have mean ADC values less than (1.31 × 10−3) mm2/s; while benign bone tumors have mean ADC values 1.43 × 10−3 mm2/s. Also, mean ADC values helped in differentiating malignant from inflammatory bony lesions as well as cystic from solid bony lesions. Conclusion: DWI has been proven to be highly useful in the differentiation of benign, malignant bone tumors and tumor like bony lesions. Measurement of ADC values improves the accuracy of the diagnosis of bone tumors and tumor like lesions. Moreover, measurement of ADC values can be used in the follow up of tumors and their response to therapy.

Keywords

• Bone
• Tumors
• Tumor-like
• Diffusion
• Functioning MRI