• Eur Spine J · May 2020

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

    • Jiahui Zhang, Yongye Chen, Yanyan Zhang, Enlong Zhang, Hon J Yu, Huishu Yuan, Yang Zhang, Min-Ying Su, and Ning Lang.
    • Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, People's Republic of China.
    • Eur Spine J. 2020 May 1; 29 (5): 1061-1070.

    PurposeTo 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.MethodsA 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.ResultsThe 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.ConclusionsThe 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.

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