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

Abstract

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. 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 K^trans and k_ep. On PET, the maximum standardized uptake value SUV_max 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. The K^trans, k_ep and SUV_max were not statistically different among malignant, benign and borderline groups (P = 0.95, 0.50, 0.11). There was no significant correlation between K^trans and SUV_max (r = - 0.20, P = 0.18), or between k_ep and SUV_max (r = - 0.16, P = 0.28). The k_ep was significantly higher in plasmacytoma than in metastasis (0.78 ± 0.17 vs. 0.61 ± 0.18, P = 0.02); in contrast, the SUV_max 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 k_ep and SUV_max was 0.79 and 0.78, respectively. 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. These slides can be retrieved under Electronic Supplementary Material.