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Diffusion-weighted MRI for detection and differentiation of musculoskeletal tumorous and tumor-like lesions in pediatric patients

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Diffusion-weighted MRI for detection and differentiation of musculoskeletal tumorous and tumor-like lesions in pediatric patients. / Neubauer, Henning; Evangelista, Laura; Hassold, Nicole; Winkler, Beate; Schlegel, Paul Gerhardt; Köstler, Herbert; Hahn, Dietbert; Beer, Meinrad.

In: WORLD J PEDIATR, Vol. 8, No. 4, 11.2012, p. 342-349.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Neubauer, H, Evangelista, L, Hassold, N, Winkler, B, Schlegel, PG, Köstler, H, Hahn, D & Beer, M 2012, 'Diffusion-weighted MRI for detection and differentiation of musculoskeletal tumorous and tumor-like lesions in pediatric patients', WORLD J PEDIATR, vol. 8, no. 4, pp. 342-349. https://doi.org/10.1007/s12519-012-0379-8

APA

Neubauer, H., Evangelista, L., Hassold, N., Winkler, B., Schlegel, P. G., Köstler, H., Hahn, D., & Beer, M. (2012). Diffusion-weighted MRI for detection and differentiation of musculoskeletal tumorous and tumor-like lesions in pediatric patients. WORLD J PEDIATR, 8(4), 342-349. https://doi.org/10.1007/s12519-012-0379-8

Vancouver

Neubauer H, Evangelista L, Hassold N, Winkler B, Schlegel PG, Köstler H et al. Diffusion-weighted MRI for detection and differentiation of musculoskeletal tumorous and tumor-like lesions in pediatric patients. WORLD J PEDIATR. 2012 Nov;8(4):342-349. https://doi.org/10.1007/s12519-012-0379-8

Bibtex

@article{19c44a0c230c4dc7b70f113090264179,
title = "Diffusion-weighted MRI for detection and differentiation of musculoskeletal tumorous and tumor-like lesions in pediatric patients",
abstract = "BACKGROUND: MRI is the diagnostic mainstay for detection and differentiation of musculoskeletal tumors. However, a projection regarding the biological dignity of lesions based on standard MRI sequences remains difficult and uncertain. This study was undertaken to analyse whether diffusion-weighted MRI (DWI) can distinguish between benign and malignant musculoskeletal tumorous and tumor-like lesions in pediatric patients.METHODS: MR examinations of 44 consecutive pediatric patients (26 girls, mean age 11±6 years) including standard sequences and DWI (b=50/800 s/mm(2)) at 1.5 or 3 Tesla were retrospectively evaluated. The study group contained 10 patients with non-treated malignant tumors and 34 patients with benign lesions. Size, relative signal intensity and apparent diffusion coefficient (ADC, unit ×10(-3) mm(2)/s) were determined in one lesion per patient.RESULTS: Mean ADC was 0.78±0.45×10(-3) mm(2)/s in patients with malignant tumors and 1.71±0.75 ×10(-3) mm(2)/s in patients with benign lesions (P<0.001). Relative operating characteristics (ROC) analysis showed a sensitivity of 90% and a specificity of 91% for malignancy, based on an ADC cut-off value of ≤1.03. On logistic regression, mean ADC and lesion size accounted for 62% of variability in benign vs. malignant tumors. For malignant tumors, the signal intensity ratio was higher on DWI than on T1w post-contrast images (P<0.002). Two cases of local tumor recurrence were diagnosed by DWI only.CONCLUSIONS: DWI shows promising results for determination of biological dignity in musculoskeletal tumors. Mean ADC ≤1.03×10(-3) mm(2)/s is a strong indicator of malignancy at the first diagnosis. The use of DWI for early diagnosis of tumor recurrence in comparison with standard MRI sequences should be evaluated in prospective studies.",
keywords = "Adolescent, Bone Neoplasms/diagnosis, Child, Child, Preschool, Diagnosis, Differential, Diffusion Magnetic Resonance Imaging, Early Detection of Cancer, Female, Humans, Infant, Male, Muscle Neoplasms/diagnosis, Neoplasm Recurrence, Local/diagnosis, ROC Curve, Sarcoma, Ewing/diagnosis, Young Adult",
author = "Henning Neubauer and Laura Evangelista and Nicole Hassold and Beate Winkler and Schlegel, {Paul Gerhardt} and Herbert K{\"o}stler and Dietbert Hahn and Meinrad Beer",
year = "2012",
month = nov,
doi = "10.1007/s12519-012-0379-8",
language = "English",
volume = "8",
pages = "342--349",
journal = "WORLD J PEDIATR",
issn = "1708-8569",
publisher = "Institute of Pediatrics of Zhejiang University",
number = "4",

}

RIS

TY - JOUR

T1 - Diffusion-weighted MRI for detection and differentiation of musculoskeletal tumorous and tumor-like lesions in pediatric patients

AU - Neubauer, Henning

AU - Evangelista, Laura

AU - Hassold, Nicole

AU - Winkler, Beate

AU - Schlegel, Paul Gerhardt

AU - Köstler, Herbert

AU - Hahn, Dietbert

AU - Beer, Meinrad

PY - 2012/11

Y1 - 2012/11

N2 - BACKGROUND: MRI is the diagnostic mainstay for detection and differentiation of musculoskeletal tumors. However, a projection regarding the biological dignity of lesions based on standard MRI sequences remains difficult and uncertain. This study was undertaken to analyse whether diffusion-weighted MRI (DWI) can distinguish between benign and malignant musculoskeletal tumorous and tumor-like lesions in pediatric patients.METHODS: MR examinations of 44 consecutive pediatric patients (26 girls, mean age 11±6 years) including standard sequences and DWI (b=50/800 s/mm(2)) at 1.5 or 3 Tesla were retrospectively evaluated. The study group contained 10 patients with non-treated malignant tumors and 34 patients with benign lesions. Size, relative signal intensity and apparent diffusion coefficient (ADC, unit ×10(-3) mm(2)/s) were determined in one lesion per patient.RESULTS: Mean ADC was 0.78±0.45×10(-3) mm(2)/s in patients with malignant tumors and 1.71±0.75 ×10(-3) mm(2)/s in patients with benign lesions (P<0.001). Relative operating characteristics (ROC) analysis showed a sensitivity of 90% and a specificity of 91% for malignancy, based on an ADC cut-off value of ≤1.03. On logistic regression, mean ADC and lesion size accounted for 62% of variability in benign vs. malignant tumors. For malignant tumors, the signal intensity ratio was higher on DWI than on T1w post-contrast images (P<0.002). Two cases of local tumor recurrence were diagnosed by DWI only.CONCLUSIONS: DWI shows promising results for determination of biological dignity in musculoskeletal tumors. Mean ADC ≤1.03×10(-3) mm(2)/s is a strong indicator of malignancy at the first diagnosis. The use of DWI for early diagnosis of tumor recurrence in comparison with standard MRI sequences should be evaluated in prospective studies.

AB - BACKGROUND: MRI is the diagnostic mainstay for detection and differentiation of musculoskeletal tumors. However, a projection regarding the biological dignity of lesions based on standard MRI sequences remains difficult and uncertain. This study was undertaken to analyse whether diffusion-weighted MRI (DWI) can distinguish between benign and malignant musculoskeletal tumorous and tumor-like lesions in pediatric patients.METHODS: MR examinations of 44 consecutive pediatric patients (26 girls, mean age 11±6 years) including standard sequences and DWI (b=50/800 s/mm(2)) at 1.5 or 3 Tesla were retrospectively evaluated. The study group contained 10 patients with non-treated malignant tumors and 34 patients with benign lesions. Size, relative signal intensity and apparent diffusion coefficient (ADC, unit ×10(-3) mm(2)/s) were determined in one lesion per patient.RESULTS: Mean ADC was 0.78±0.45×10(-3) mm(2)/s in patients with malignant tumors and 1.71±0.75 ×10(-3) mm(2)/s in patients with benign lesions (P<0.001). Relative operating characteristics (ROC) analysis showed a sensitivity of 90% and a specificity of 91% for malignancy, based on an ADC cut-off value of ≤1.03. On logistic regression, mean ADC and lesion size accounted for 62% of variability in benign vs. malignant tumors. For malignant tumors, the signal intensity ratio was higher on DWI than on T1w post-contrast images (P<0.002). Two cases of local tumor recurrence were diagnosed by DWI only.CONCLUSIONS: DWI shows promising results for determination of biological dignity in musculoskeletal tumors. Mean ADC ≤1.03×10(-3) mm(2)/s is a strong indicator of malignancy at the first diagnosis. The use of DWI for early diagnosis of tumor recurrence in comparison with standard MRI sequences should be evaluated in prospective studies.

KW - Adolescent

KW - Bone Neoplasms/diagnosis

KW - Child

KW - Child, Preschool

KW - Diagnosis, Differential

KW - Diffusion Magnetic Resonance Imaging

KW - Early Detection of Cancer

KW - Female

KW - Humans

KW - Infant

KW - Male

KW - Muscle Neoplasms/diagnosis

KW - Neoplasm Recurrence, Local/diagnosis

KW - ROC Curve

KW - Sarcoma, Ewing/diagnosis

KW - Young Adult

U2 - 10.1007/s12519-012-0379-8

DO - 10.1007/s12519-012-0379-8

M3 - SCORING: Journal article

C2 - 23151862

VL - 8

SP - 342

EP - 349

JO - WORLD J PEDIATR

JF - WORLD J PEDIATR

SN - 1708-8569

IS - 4

ER -