Accuracy of chemical shift MR imaging in diagnosing indeterminate bone marrow lesions in the pelvis: review of a single institution's experience.

Objective: To re-assess the accuracy of chemical shift imaging in diagnosing indeterminate bone marrow lesions as benign or malignant.Materials and Methods: We retrospectively reviewed our experience with MR imaging of the pelvis to assess the accuracy of chemical shift imaging in distinguishing ben...

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Published in:Skeletal Radiology Vol. 43; no. 8; pp. 1079 - 1085
Main Authors: Kohl, Chad A, Chivers, F Spencer, Lorans, Roxanne, Roberts, Catherine C, Kransdorf, Mark J
Format: research Journal Article
Published: Springer Nature Aug2014
Online Access:View this record in EBSCOhost
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      dt: Aug2014
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      pub: Springer Nature
      place: New York, New York
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        atl: Accuracy of chemical shift MR imaging in diagnosing indeterminate bone marrow lesions in the pelvis: review of a single institution's experience.
      aug:
        au:
          Kohl, Chad A
          Chivers, F Spencer
          Lorans, Roxanne
          Roberts, Catherine C
          Kransdorf, Mark J
        affil: Department of Radiology, Mayo Clinic, 5777 E Mayo Boulevard, Phoenix, AZ, 85054, USA.
      sug:
        subj:
          Bone Marrow Pathology
          Bone Marrow Neoplasms Diagnosis
          Magnetic Resonance Imaging Methods
          Pelvis Pathology
          Adult
          Aged
          Aged, 80 and Over
          Biopsy
          Female
          Human
          Male
          Middle Age
          Observer Bias
          ROC Curve
          Reproducibility of Results
          Retrospective Design
          Sensitivity and Specificity
          Adult: 19-44 years
          Aged: 65+ years
          Aged, 80 & over
          Middle Aged: 45-64 years
          Female
          Male
      ab: Objective: To re-assess the accuracy of chemical shift imaging in diagnosing indeterminate bone marrow lesions as benign or malignant.Materials and Methods: We retrospectively reviewed our experience with MR imaging of the pelvis to assess the accuracy of chemical shift imaging in distinguishing benign from malignant bone lesions. Two musculoskeletal radiologists retrospectively reviewed all osseous lesions biopsied since 2006, when chemical shift imaging was added to our routine pelvic imaging protocol. Study inclusion criteria required (1) MR imaging of an indeterminate bone marrow lesion about the pelvis and (2) subsequent histologic confirmation. The study group included 50 patients (29 male, 21 female) with an average age of 67 years (range, 41-89 years). MR imaging results were evaluated using biopsy results as the "gold standard."Results: There were 27 malignant and 23 benign lesions. Chemical shift imaging using an opposed-phase signal loss criteria of less than 20 % to indicate a malignant lesion, correctly diagnosed 27/27 malignant lesions and 14/23 benign lesions, yielding a 100 % sensitivity, 61 % specificity, 75 % PPV, 100 % NPV, and 82 % accuracy. The area under the receiver operator characteristic (ROC) curve was 0.88. The inter-rater and intra-rater agreement K values were both 1.0.Conclusions: Chemical shift imaging is a useful adjunct MR technique to characterize focal and diffuse marrow abnormalities on routine non-contrast pelvic imaging. It is highly sensitive in identifying malignant disease. Despite its lower specificity, the need for biopsy could be eliminated in more than 60 % of patients with benign disease.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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