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Diagnosis of spinal lesions using perfusion parameters measured by DCE-MRI and metabolism parameters measured by PET/CT

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Abstract

Purpose

To investigate the correlation of parameters measured by dynamic-contrast-enhanced MRI (DCE-MRI) and 18F-FDG PET/CT in spinal tumors, and their role in differential diagnosis.

Methods

A total of 49 patients with pathologically confirmed spinal tumors, including 38 malignant, six benign and five borderline tumors, were analyzed. The MRI and PET/CT were done within 3 days, before biopsy. On MRI, the ROI was manually placed on area showing the strongest enhancement to measure pharmacokinetic parameters Ktrans and kep. On PET, the maximum standardized uptake value SUVmax was measured. The parameters in different histological groups were compared. ROC was performed to differentiate between the two largest subtypes, metastases and plasmacytomas. Spearman rank correlation was performed to compare DCE-MRI and PET/CT parameters.

Results

The Ktrans, kep and SUVmax were not statistically different among malignant, benign and borderline groups (P = 0.95, 0.50, 0.11). There was no significant correlation between Ktrans and SUVmax (r = − 0.20, P = 0.18), or between kep and SUVmax (r = − 0.16, P = 0.28). The kep was significantly higher in plasmacytoma than in metastasis (0.78 ± 0.17 vs. 0.61 ± 0.18, P = 0.02); in contrast, the SUVmax was significantly lower in plasmacytoma than in metastasis (5.58 ± 2.16 vs. 9.37 ± 4.26, P = 0.03). In differential diagnosis, the AUC of kep and SUVmax was 0.79 and 0.78, respectively.

Conclusions

The vascular parameters measured by DCE-MRI and glucose metabolism measured by PET/CT from the most aggressive tumor area did not show a significant correlation. The results suggest they provide complementary information reflecting different aspects of the tumor, which may aid in diagnosis of spinal lesions.

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Abbreviations

AUC:

Area under the curve

CT:

Computed tomography

DCE-MRI:

Dynamic-contrast-enhanced magnetic resonance imaging

DWI:

Diffusion-weighted imaging

FDG:

Fluorodeoxyglucose

PET:

Positron emission tomography

ROC:

Receiver operating characteristic

ROI:

Region of interest

SE:

Signal enhancement

SUV:

Standardized uptake value

TR:

Repetition time

TE:

Echo time

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Acknowledgements

This study was supported by National Natural Science Foundation of China (81701648 and 81971578), NIH R01 CA127927 and Key Clinical Projects of the Peking University Third Hospital (BYSY2018007).

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Authors and Affiliations

  1. Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, People’s Republic of China

    Jiahui Zhang, Yongye Chen, Enlong Zhang, Huishu Yuan & Ning Lang

  2. Department of Nuclear Medicine, Peking University Third Hospital, Beijing, People’s Republic of China

    Yanyan Zhang

  3. Department of Radiological Sciences, Center for Functional Onco-Imaging, University of California, 164 Irvine Hall, Irvine, CA, 92697-5020, USA

    Hon J. Yu, Yang Zhang & Min-Ying Su

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  1. Jiahui Zhang
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  4. Enlong Zhang
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Correspondence to Min-Ying Su or Ning Lang.

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Zhang, J., Chen, Y., Zhang, Y. et al. Diagnosis of spinal lesions using perfusion parameters measured by DCE-MRI and metabolism parameters measured by PET/CT. Eur Spine J 29, 1061–1070 (2020). https://doi.org/10.1007/s00586-019-06213-9

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  • DOI: https://doi.org/10.1007/s00586-019-06213-9

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