Oh E, Yoon Y C, Kim J H, Kim K
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea.
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea.
Clin Radiol. 2017 Jul;72(7):552-559. doi: 10.1016/j.crad.2017.02.017. Epub 2017 Mar 18.
To evaluate and compare the diagnostic performance of quantitative parameters derived from diffusion-weighted imaging (DWI) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in differentiating benign and malignant bone tumours.
Fifty-five patients (age range, 21-82 years; mean age, 55 years) underwent pretreatment MRI. Apparent diffusion coefficient (ADC) values were calculated by DWI. The DCE-MRI data were analysed for the volume transfer constant (K), extravascular extracellular volume fraction (V), and volume rate constant (K), and K/ADC ratio. Each parameter's performance was evaluated using the area under the receiver operating characteristic (ROC) curv (AUC), and their AUCs were compared. ROC curves were analysed and each parameter's optimal cut-off value was determined, from which each parameter was evaluated for sensitivity, specificity, accuracy, and positive and negative predictive values. The odds ratio (OR) with 95% confidence interval for detecting malignant bone lesions after adjusting the age factor of each parameter was estimated.
All parameter values (except V) were significantly different between benign and malignant bone tumours (p<0.05). The K had a significantly greater AUC than V (p=0.03). The K/ADC and K had the best sensitivity (0.917) and specificity (0.632), respectively. The K and K/ADC had the best positive (0.811) and negative (0.769) predictive values, respectively. The OR was highest for K/ADC (17.38; p=0.0013).
The K, K, ADC, and K/ADC could help to detect malignant lesions from bone tumours and K/ADC appears to be the superior variable among them.
评估并比较扩散加权成像（DWI）和动态对比增强磁共振成像（DCE-MRI）得出的定量参数在鉴别良性和恶性骨肿瘤中的诊断性能。
55例患者（年龄范围21 - 82岁；平均年龄55岁）接受了治疗前MRI检查。通过DWI计算表观扩散系数（ADC）值。对DCE-MRI数据进行分析，得出容积转运常数（K）、血管外细胞外容积分数（V）、容积速率常数（K）以及K/ADC比值。使用受试者操作特征（ROC）曲线下面积（AUC）评估每个参数的性能，并比较它们的AUC。分析ROC曲线并确定每个参数的最佳截断值，据此评估每个参数的敏感性、特异性、准确性以及阳性和阴性预测值。估计在调整每个参数的年龄因素后检测恶性骨病变的95%置信区间的优势比（OR）。
良性和恶性骨肿瘤之间所有参数值（除V外）均有显著差异（p<0.05）。K的AUC显著大于V（p = 0.03）。K/ADC和K分别具有最佳敏感性（0.917）和特异性（0.632）。K和K/ADC分别具有最佳阳性（0.811）和阴性（0.769）预测值。K/ADC的OR最高（17.38；p = 0.0013）。
K、K、ADC和K/ADC有助于检测骨肿瘤中的恶性病变，且K/ADC似乎是其中最具优势的变量。
