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Accuracy of dynamic contrast-enhanced MRI (DCE-MRI) and diffusion-weighted imaging-apparent diffusion coefficient (DWI-ADC) in assessing characteristics of primary bone tumors based on histopathology results
Annisa D.S.
Gazzetta Medica Italiana Archivio Per Le Scienze Mediche
Q4Abstract
BACKGROUND: Primary bone tumors originate from the cells that make up bone tissue. In musculoskeletal imaging, magnetic resonance imaging (MRI) is an important tool in modern oncology. Techniques such as diffusion-weighted imaging (DWI) and dynamic contrast-enhanced MRI (DCE-MRI) can help to differentiate benign and malignant tumors. This study evaluates the accuracy of DCE-MRI and diffusion-weighted imaging-apparent diffusion coefficient (DWI-ADC) in the characterization of primary bone tumors and correlates them with histopathology to improve accuracy and therapy monitoring.METHODS: This retrospective cross-sectional study in Wahidin Sudirohusodo Hospital from January 2022 to June 2024, used Picture Archiving and Communication System (PACS) data to assess the accuracy of DCE-MRI and DWI-ADC in primary bone tumor characterization based on histopathology. Data were analyzed with SPSS v29.0, employing Mann-Whitney Test, c2 Test, and receiver-operating characteristic (ROC) curve analysis, with significance at P<0.05.RESULTS: This study analyzed 58 samples, and showed significant differences in Ve, Ktrans, Kep, MaxSlope, ADC value, and DWI-ADC between malignant and benign tumors (P<0.001). Malignant tumors had an average ADC of 0.59±0.19 mm2/s, while benign tumors averaged 1.22±0.43 mm2/s. The main diagnostic potential was observed in ADC area under curve (AUC 0.921), MaxSlope (AUC 0.987), and Kep (AUC 0.942), Ktrans (AUC 0.886). Ktrans sensitivity and specificity values were 95.3% sensitivity and 73.3% specificity. Kep sensitivity is 83.7% and specificity is 93.3%. MaxSlope is 97.7% sensitivity and 80.0% specificity. Ve sensitivity is 90.7% and specificity is 73.3%. ADC values are 93.3% and 88.4% sensitivity and specificity, and DWI-ADC had 100% sensitivity and 81.4% specificity.CONCLUSIONS: There were statistically significant differences in MRI-DCE value (qualitative, semiquantitative, and quantitative) and ADC value in distinguishing the characteristics of primary bone tumors.