scholarly journals Diffusion-weighted Magnetic Resonance Imaging in the Diagnosis of Bone Tumors: Preliminary Results

2013 ◽  
Vol 3 ◽  
pp. 63 ◽  
Author(s):  
Yeliz Pekcevik ◽  
Mehmet Onur Kahya ◽  
Ahmet Kaya
Keyword(s):  
Magnetic Resonance ◽  
Bone Tumors ◽  
Malignant Tumors ◽  
Receiver Operating Curve ◽  
Benign Tumors ◽  
Single Shot ◽  
Malignant Bone Tumors ◽  
Diffusion Weighted ◽  
Adc Values ◽  
The Mean

Objective: The study aims to determine whether apparent diffusion coefficient (ADC) can help differentiate benign and malignant bone tumors. Materials and Methods: From January 2012 to February 2013, we prospectively included 26 patients. Of these 15 patients were male and 11 were female; ranging in age from 8 to 76 years (mean age, 34.5 years). Diffusion-weighted magnetic resonance (MR) imaging was obtained with a single-shot echo-planar imaging sequence using a 1.5T MR scanner. We grouped malignant lesions as primary, secondary, and primary tumor with chondroid matrix. The minimum ADC was measured in the tumors and mean minimum ADC values were selected for statistical analysis. ADC values were compared between malignant and benign tumors using the Mann-Whitney U-test and receiver operating curve analysis were done to determine optimal cut-off values. Results: The mean ADC values from the area with lowest ADC values of benign and malignant tumors were 1.99 ± 0.57 × 10−3 mm2/s and 1.02 ± 1.0 × 10−3 mm2/s, respectively. The mean minimum ADC values of benign and malignant tumors were statistically different (P = 0.029). With cut-off value of 1.37 (10−3 mm2/s), sensitivity was 77.8% and specificity was 82.4%, for distinguishing benign and malignant lesion. Benign and secondary malignant tumors showed statistically significant difference (P = 0.002). There was some overlap in ADC values between benign and malignant tumors. The mean minimum ADC values of benign and malignant chondroid tumors were high. Giant cell tumor, non-ossifying fibroma and fibrous dysplasia showed lower ADC values. Conclusion: Although there is some overlap, ADC values of benign and malignant bone tumors seem to be different. Further studies with larger patient groups are needed to find an optimal cut-off ADC value.

Diffusion-weighted imaging using ADC mapping as an imaging biomarker for breast cancer invasiveness.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 11093-11093
Author(s):  
Hubert Bickel ◽  
Wolfgang Bogner ◽  
Peter Christian Dubsky ◽  
Rupert Bartsch ◽  
Margaretha Rudas ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Diffusion Weighted Imaging ◽  
Malignant Tumors ◽  
Imaging Biomarker ◽  
Benign Tumors ◽  
Non Invasive ◽  
Diffusion Weighted ◽  
Cancer Invasiveness ◽  
Adc Values ◽  
Breast Cancer Invasiveness

11093 Background: Recently, functional imaging techniques such as diffusion weighted imaging (DWI) have been added to routine MR and have shown great potential for improving breast cancer diagnosis. DWI depicts cellular diffusivity on a molecular level and can be quantified using the apparent diffusion coefficient (ADC). In malignant tumors diffusivity is restricted, leading to lower ADC values than benign tumors. The aim of this study was to proof, that DWI can be used to differentiate benign from malignant tumors and to elucidate if ADC can serve as an imaging biomarker for breast cancer invasiveness. Methods: In this IRB-approved study 250 patients with 267 suspicious breast lesions (BI-RADS IV-V) were included. All patients underwent routine MR at 3T. A DWI-sequence was added to a standard imaging protocol, increasing measurement time by 2:30 min. The lesions were identified in routine MR and DWI sequences and ADC values of the lesions were calculated. Histopathology was used as the standard of reference for all lesions. Appropriate statistical tests were used to compare the ADC values of benign and malignant tumors (cut-off value 1.25×10-3mm²/s), of invasive and non-invasive disease and between different invasive tumor subtypes. Results: There were 91 benign (mean ADC 1.58×10-3mm²/s) and 176 malignant (.94×10-3mm²/s) lesions, sensitivity and specificity were 94.3% (PPV 95.4%, CI 0.91-0.98) and 91.2% (NPV 89.2%, CI 0.81-0.94). 155 lesions were invasive cancers (median ADC .90×10-3mm²/s), while 21 were non-invasive ductal carcinoma in situ (1.22×10-3mm²/s). The invasive cancers were 130 invasive ductal (median ADC .91×10-3mm²/s) and 25 invasive lobular cancers (.83×10-3mm²/s). ADC was significantly different between benign and malignant lesions (p<.001) and between invasive and non-invasive cancers (p<.001), while no significant difference could be found between the invasive cancer subtypes (p=.163). Conclusions: Diffusion-weighted imaging reliably allows differentiation of benign and malignant breast tumors. The data suggest that ADC can be used as a non-invasive imaging biomarker for breast cancer invasiveness and may be of importance to treatment planning and outcome in breast cancer patients.

scholarly journals Comparison between Benign and Malignant Primary Bone Tumors-A Histopathological Study of 119 Cases

2018 ◽  
Vol 29 (2) ◽  
pp. 74
Author(s):  
Farah Falah Hasan ◽  
Haider Lateef Mohammed
Keyword(s):  
Bone Tumors ◽  
Benign Tumors ◽  
Histopathological Study ◽  
Malignant Bone Tumors ◽  
Female Ratio ◽  
Primary Bone Tumors ◽  
Benign Bone Tumors ◽  
Common Location ◽  
Primary Bone ◽  
The Mean

This is a prospective study done at Al wasity teaching hospital for reconstructive surgeries in Bagdad in a period from November 2014 to April 2017, using a Total of 119 samples of primary bone tumors which were diagnosed both histopathologically and radiologically. The main objectives of this study was to make a comparison between benign and malignant bone tumors. Immunohistochemical staining was done to confirm the diagnosis of primary malignant bone tumors and the proliferative index of them were carefully evaluated. Out of 119 samples of primary bone tumors used in this study ,100 (84%) were benign and borderline(osteoclastoma) and 19(16%) were malignant, the mean age for benign tumors was lower than the mean age for primary malignant one and both frequently present in the 2nd decade of life, male to female ratio for benign bone tumors was 3\2 and 8.5\1 for primary malignant one, femure was the most common location for benign bone tumors while tibia was the most common bone affected by primary malignant bone tumors. the study also showed that the most common benign bone tumors were osteochondromas(67%) and most common primary malignant bone tumors were osteosarcomas(52.63%),thus this study rise a conclusion that in general, primary bone tumors were mainly benign, occurred predominantly in the second decade of life with a male preponderance

scholarly journals Use of Histogram Analysis in Diffusion-Weighted Magnetic Resonance Imaging for Differentiation of Renal Tumor Subgroups

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Gurcan Erbay ◽  
Mehmet Resit Goren ◽  
Elif Karadeli ◽  
Burcak Pekoz ◽  
Zafer Koc ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Magnetic Resonance ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Magnetic Resonance Images ◽  
Histogram Analysis ◽  
Renal Tumors ◽  
Diffusion Weighted ◽  
Adc Values ◽  
The Mean

Background: The histopathological differentiation of renal neoplasms can be challenging via imaging. Objectives: To evaluate differences in histogram parameters on apparent diffusion coefficient (ADC) maps and to investigate the efficacy of histogram analysis in differentiation of oncocytomas from malignant renal neoplasm (MRN) subgroups. Patients and Methods: In this cross-sectional, retrospective study, the texture parameters of diffusion-weighted magnetic resonance images (DW-MRI) were evaluated in 65 patients with renal tumors (nine cases of oncocytoma and 59 cases of MRN) for a histological analysis. Results: A total of 68 lesions from 50 male and 15 female patients, with a median age of 55.4 years, were examined in this study. There were significant differences in the mean, median, and peak ADC values, as well as ADC percentiles, between the oncocytoma and MRN subgroups. Regarding the histopathological features of the lesions, 9 (11.5%) cases of oncocytomas, 23 (29.5%) cases of clear cell renal carcinoma (ccRCC), 14 (17.9%) cases of papillary renal cell carcinoma (pRCC), 12 (15.4%) cases of chromophobe renal cell carcinoma (chRCC), and 10 (12.8%) other tumors (including four cases of transitional cell carcinoma, four cases of non-Hodgkin’s lymphoma, and two cases of primitive neuroectodermal tumor) were identified. Significant differences were found in the mean and median ADC values between the oncocytoma, pRCC, chRCC, and other MRN subgroups. Moreover, significant differences were found in the mean and median ADC values between the ccRCC, pRCC, and chRCC subgroups. There were also significant differences in the percentiles of mean and median ADCs between oncocytomas and pRCC, chRCC, and other MRN subgroups. However, there were no significant differences in the mean and median ADCs (including the percentile histogram analysis) or the peak ADC between the oncocytoma and ccRCC groups. The mean, median, and percentile of ADC for renal masses were superior to kurtosis, skewness, and entropy. Conclusion: Although differentiation between ccRCC and oncocytoma was not possible by only measuring the mean, median, and peak ADC values, the histogram analysis of ADCs may improve differentiation between the MRN subgroups. Clearly, ADC cannot be used to differentiate between oncocytomas and MRNs.

Parotid gland tumors: comparison of conventional and diffusion-weighted MRI findings with histopathological results

2020 ◽  
pp. 20200391
Author(s):  
Can Zafer Karaman ◽  
Ahmet Tanyeri ◽  
Recep Özgür ◽  
Veli Süha Öztürk
Keyword(s):  
Parotid Gland ◽  
Pleomorphic Adenoma ◽  
Malignant Tumors ◽  
Mri Findings ◽  
Parotid Gland Tumors ◽  
Conventional Mri ◽  
Diffusion Weighted ◽  
Pleomorphic Adenomas ◽  
Adc Values ◽  
The Mean

Objectives: The aim of this study was to investigate the relationship between pathological classification of parotid gland tumors and conventional MRI – diffusion-weighted imaging findings and also contribute the possible effect of apparent diffusion coefficient (ADC) to diagnosis. Methods: 60 patients with parotid masses diagnosed using histopathology and/or cytology were enrolled in this retrospective study. All patients were evaluated using a 1.5 T MRI. Demographic features, conventional MRI findings, and ADC values (mean, minimum, maximum, and relative) were recorded. MRI findings and ADC values were compared between benign–malignant groups and pleomorphic adenoma vs Warthin’s tumor groups. Results: 60 tumors (48 benign, 12 malignant) were evaluated in a total of 60 patients (39 males, 21 females). The mean age was 59 (±14, 18–86) years old; the mean lesion size was 26 (±10, 11–61) mm. On the texture of conventional MRI, T2 dominantly hyperintense/with hypointensity signal was seen in 87% of pleomorphic adenomas and T2 dominantly hypointense/with hyperintesity signal was encountered in 64% of all Warthin’s tumors. Seven (28%) Warthin’s tumors were misdiagnosed as pleomorphic adenomas and two others (8%) as malignant tumors. The commonly used mean ADC value was 1.6 ± 0.6 × 10–3 mm2 s−1 for benign tumors, 0.8 ± 0.3 × 10–3 mm2 s−1 for malign tumors, 1 (0.9–1.8) × 10–3 mm2 s−1 for Warthin’s tumors, and 1.9 ± 0.3 × 10–3 mm2 s−1 for pleomorphic adenomas. There was a statistically significant difference in ADC values between benign-malignant tumors and pleomorphic adenomas-Warthin’s tumors. Conclusions: Warthin’s tumor may occasionally be misdiagnosed as pleomorphic adenoma and malignant tumor because of variable morphologic features. In addition to benign–malignant differentiation, the added ADC measurement may also be useful for differentiating Warthin’s tumors from pleomorphic adenomas.

scholarly journals Polymorbidity and heterogeneity of intact bone tissue in patients with malignant and metastatic bone tumors

2019 ◽  
pp. 33-37 ◽  
Author(s):  
Nikolay Ternovoy ◽  
Oleg Drobotun ◽  
Nikolay Kolotilov
Keyword(s):  
Bone Tumors ◽  
Malignant Tumors ◽  
Benign Tumors ◽  
Control Group ◽  
Malignant Bone Tumors ◽  
Tomographic Images ◽  
Computed Tomographic ◽  
Treatment Side Effects ◽  
Intact Bone

Polymorbidity is the presence of several synchronically occurring diseases (genetically or pathogenetically related or unrelated) in one person at different stages and phases of their development, is accompanied by higher mortality rates, higher disability rates, treatment side effects, increased consumption of the patient’s body resources, lower quality of life. The purpose of the article is to demonstrate the association of polymorbidity and intact bone tissues’ heterogeneity in patients with malignant and metastatic bone tumors. Material and methods. 16 patients with benign bone tumors, 25 – with primary malignant bone tumors and 22 – with metastatic bone tumors were investigated with multispiral tomography scanner: 33 (52.4 %) men and 30 (47.6 %) women aged 25 to 75 years. The control group consisted of 37 patients with suspected tumor lesions of the bones, but the diagnosis was not confirmed. To assess polymorbidity in patients, the CIRS-G system was applied. Conclusion. An increase in polymorbidity level is associated with a decrease in RGD and an increase in the texture heterogeneity of computed tomographic images of the spongy and compact bones (the pattern is reliable, P <0.01) in the series: practically healthy individuals, patients with benign tumors, patients with malignant tumors, patients with metastatic tumors.

scholarly journals Multiple b values of diffusion-weighted magnetic resonance imaging in evaluation of solid head and neck masses

2019 ◽  
Vol 50 (1) ◽  
Author(s):  
Rania Sobhy Abou khadrah ◽  
Haytham Haroon Imam
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Head And Neck ◽  
Resonance Imaging ◽  
Adc Value ◽  
Neck Masses ◽  
Adc Values ◽  
Weighted Magnetic Resonance Imaging ◽  
The Mean ◽  
Head And Neck Masses

Abstract Background Differentiation between malignant and benign masses is essential for treatment planning and helps in improving the prognosis of malignant tumors; the aim of this work is to determine the role of diffusion-weighted magnetic resonance imaging (DW-MRI) and the apparent diffusion coefficient (ADC) in the differentiation between benign and malignant solid head and neck masses by comparing diagnostic performance of low b values (0.50 and 400 s/mm2) versus high b values (800 and 1000 s/mm2) and comparing the result with histopathological finding. Results The study included 60 patients (34 male and 26 female) with solid head and neck masses > 1 cm who referred to radiodiagnosis department for MRI evaluation. Multiple b values were used 50, 400, 800, and 1000 s/mm2 (at least 2 b values). DWI and ADC value of all 60 patients were acquired. Mean ADC values of both malignant and benign masses were statistically measured and compared, and cut off value was determined. Solid head and neck masses in our study DWI with the use of high b value 800 and 1000 s/mm2 were of higher significance (P value 0.001*). There was a significant difference in the mean ADC value between benign and malignant masses (P < 0.01); solid masses were divided into 2 categories: (a) malignant lesions 46.7% (n = 28) with mean ADC value (0.82 ± 0.19) × 10−3 s/mm2 and (b) benign lesions 53.3% (n = 32) with mean ADC value (2.05 ± 0.46) × 10−3 s/mm2) with ADC cutoff value of 1.0 × 10−3 s/mm2 and 94% sensitivity, 93% specificity, negative predictive value (NPV) = 94%, positive predictive value (PPV) 93%, and an accuracy of 93.5%. Conclusion The DWI with ADC mapping were valuable as non-invasive tools in differentiating between benign and malignant solid head and neck masses. The use of high b value 800 and 1000 s/mm2 was of higher significance (P value 0.001*) in differentiation between benign and malignant lesion than that with low b values 0, 50, and 400 s/mm2 (0.01). The mean ADC values were significantly lower in malignant solid masses. Attention had to be paid to the choice of b values in MRI-DWI in the head and neck region.

Does diffusion-weighted magnetic resonance imaging have a place in the differential diagnosis of brucella sacroiliitis and seronegative spondyloarthropathy?

2020 ◽  
pp. 028418512093837
Author(s):  
Sunay Sibel Karayol ◽  
Kudret Cem Karayol
Keyword(s):  
Magnetic Resonance Imaging ◽  
Bone Marrow ◽  
Differential Diagnosis ◽  
Magnetic Resonance ◽  
Control Group ◽  
Resonance Imaging ◽  
Visual Evaluation ◽  
Mean Values ◽  
Diffusion Weighted ◽  
The Mean

Background The aim of this study is to investigate the role of diffusion-weighted imaging (DWI) in the differential diagnosis of sacroiliitis. Purpose To compare the sacroiliac magnetic resonance imaging (MRI) examinations of patients with suspected active sacroiliitis with patients with acute SpA MR findings and the DWI examinations of patients with acute brucella sacroiliitis, and thereby determine whether DWI can contribute to the differential diagnosis. Material and Methods A total of 84 patients were included in the study and were separated into three groups: group 1 (13 women, 6 men) comprised cases with brucella positive for sacroiliitis; group 2 (17 women, 19 men) comprised cases negative for brucella but with sacroiliitis; and group 3 (16 women, 13 men) comprised cases negative for brucella and sacroiliitis. Results The mean bone marrow apparent diffusion coefficient (ADC) values independently of edema were determined as 0.71 × 10−3 in sacroiliitis and brucella-positive patients, as 0.53 × 10−3 in brucella-negative and sacroiliitis-positive patients, and as 0.43 × 10−3 in the control group of brucella-negative sacroiliitis-negative patients. In the ADC measurements taken from areas of evident edema in patients with sacroiliitis, the mean values were 0.13 × 10−3 in the brucella-positive group and 0.12 × 10−3 in the brucella-negative group. Conclusion By adding DWI, which is a rapid MR sequence, to sacroiliac joint MR examination, normal bone marrow and bone marrow with sacroiliitis can be objectively differentiated with ADC measurements in addition to visual evaluation.

scholarly journals KPNA2 expression is a potential marker for differential diagnosis between osteosarcomas and other malignant bone tumor mimickers

2020 ◽  
Author(s):  
Lucen Jiang ◽  
Jianghuan Liu ◽  
Qingzhu Wei ◽  
Yiyang Wang
Keyword(s):  
Bone Tumor ◽  
Bone Tumors ◽  
Diagnostic Value ◽  
Benign Tumors ◽  
Malignant Bone Tumor ◽  
Malignant Bone Tumors ◽  
Potential Marker ◽  
Tumors Of Bone ◽  
Bone Sarcomas ◽  
Malignant And Benign Tumors

Abstract Background Karyopherin α 2 (KPNA2), a member of the Karyopherin α family, has been observed in several cancers but lack substantial investigation in malignant bone tumors. The purpose of the current study was to evaluate KPNA2 expression level and its utility as a novel diagnostic biomarker in osteosarcomas and their malignant bone tumor mimickers, such as chondrosarcomas and Ewing sarcomas.Method We investigated the expression of KPNA2 protein by immunohistochemistry on paraffin embedded surgical specimens from 217 patients with malignant and benign tumors of bone, including 81 osteosarcomas, 42 chondrosarcomas, 9 Ewing sarcomas, 28 osteoid osteoma, 20 osteochondroma and 37 Chondroblastoma. Immunoreactivity was scored semi quantitatively based on stain extent and intensity.Results Seventy one of 81 (87.7%) osteosarcomas, zero of 42 (0%) chondrosarcomas and one of 9 (11.1%) Ewing sarcomas showed immunoreactivity for KPNA2. Negative KPNA2 expression was observed in all of benign bone tumors. Much more positive expression of KPNA2 was found in osteosarcomas as compared with chondrosarcomas and Ewing sarcomas. The sensitivity and specificity of KPNA2 immuno-expression for osteosarcoma was 87.7% and 100%, respectively. In several subtypes of osteosarcomas, immunohistochemical expression of KNA2 was more frequent in osteoblastic (94.5%), with 39 (70.9%) showing strong-intensity staining. KPNA2 positivity was observed in eleven of 13 (84.6%) chondroblastic, three of 6 (50%) fibroblastic, three of 4 (75%) telangiectatic and two of 3 (66.7%) giant cell-rich osteosarcoma. Stronger-intensity staining was observed in osteoblastic osteosarcoma.Conclusion KPNA2 is most frequently expressed in osteosarcomas, particularly in osteoblastic and chondroblastic tumors, but is rarely positive in chondrosarcomas and Ewing sarcomas. This feature may have diagnostic value since it is very useful for distinguishing between osteosarcomas and other bone sarcomas mimickers. This report supports KPNA2 as a novel marker for the diagnosis of osteosarcoma.

scholarly journals Intercalary Reconstruction after Wide Resection of Malignant Bone Tumors of the Lower Extremity Using a Composite Graft with a Devitalized Autograft and a Vascularized Fibula

Sarcoma ◽  
2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Koichi Ogura ◽  
Shimpei Miyamoto ◽  
Minoru Sakuraba ◽  
Tomohiro Fujiwara ◽  
Hirokazu Chuman ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Bone Tumors ◽  
Callus Formation ◽  
Wide Resection ◽  
Rigid Fixation ◽  
Malignant Bone Tumors ◽  
Fibula Graft ◽  
Vascularized Fibula ◽  
The Mean ◽  
Vascularized Fibula Graft

Introduction. Although several intercalary reconstructions after resection of a lower extremity malignant bone tumor are reported, there are no optimal methods which can provide a long-term reconstruction with fewest complications. We present the outcome of reconstruction using a devitalized autograft and a vascularized fibula graft composite.Materials and Methods.We conducted a retrospective review of 11 patients (7 males, 4 females; median age 27 years) undergoing reconstruction using a devitalized autograft (pasteurization (n=6), deep freezing (n=5)) and a vascularized fibula graft composite for lower extremity malignant bone tumors (femur (n=10), tibia (n=1)).Results. The mean period required for callus formation and bone union was 4.4 months and 9.9 months, respectively. Four postoperative complications occurred in 3 patients: 2 infections (1 pasteurized autograft, 1 frozen autograft) and 1 fracture and 1 implant failure (both in pasteurized autografts). Graft removal was required in 2 patients with infections. The mean MSTS score was 81% at last follow-up.Conclusions.Although some complications were noted in early cases involving a pasteurized autograft, our novel method involving a combination of a frozen autograft with a vascularized fibula graft and rigid fixation with a locking plate may offer better outcomes than previously reported allografts or devitalized autografts.

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