Abstract
Purpose:To evaluate the correlation of maximum standardized uptake values (SUVmax) of 18F-Fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) with the apparent diffusion coefficient (ADC) of diffusion weighted imaging (DWI) in musculoskeletal malignancies.Methods:Institutional ethics committee approved this retrospective study. Twenty-seven patients (mean age: 44.85 ± 24.07; 17 men and 10 women) with a total of 29 musculoskeletal tumors underwent both FDG-PET/CT and DWI between January 2017 and March 2020. Region-of-interest (ROI)-based maximal standardized uptake values (SUVmax) of the tumors were measured on FDG-PET/CT images. Two radiologists measured lesions’ mean and minimum apparent diffusion coefficient (ADCmean and ADCmin) using five distinct ROIs on DWI images. Pearson correlation analysis was used to assess the correlation between SUVmax and ADC values.Results:There were 18 soft tissue tumors (62.1%) and 11 bone tumors (37.9%) with a mean maximum diameter of 9.4 ± 6.2 cm. The mean SUVmax, ADCmean and ADCmin of the whole lesions were 12.93 ± 9.63, 0.85 ± 0.28 × 10–3mm2/s and 0.61 ± 0.27 × 10–3mm2/s, respectively. SUVmax had a weak correlation with tumor maximum diameter (r = 0.378, p = 0.043), whereas ADCmean and ADCmin had none. There was strong inverse correlation between SUVmax and both ADCmean (r = –0.616, p < 0.001) and ADCmin (r = –0.638, p < 0.001).Conclusion:In musculoskeletal tumors, quantitative markers of FDG uptake and diffusion restriction strongly correlate.
Highlights
Diffusion-weighted imaging (DWI) and 18F-Fluorodeoxy glucose-positron emission tomography/computed tomography (FDG-PET/CT) are commonly used imaging modalities for the evaluation of various oncologic processes, including musculoskeletal tumors [1,2,3,4,5,6]
Apparent diffusion coefficient (ADC) derived from DWI has been reported to have a role in predicting malignancy and aggressiveness of the lesion [12,13,14]
The aim of this study was to evaluate whether there is a correlation between the SUVmax of FDG-PET/CT and apparent diffusion coefficient (ADC) values of DWI in musculoskeletal tumors
Summary
Diffusion-weighted imaging (DWI) and 18F-Fluorodeoxy glucose-positron emission tomography/computed tomography (FDG-PET/CT) are commonly used imaging modalities for the evaluation of various oncologic processes, including musculoskeletal tumors [1,2,3,4,5,6]. As DWI shows the diffusivity of water molecule in the examined tissue, restricted diffusion reflects cellular abundance and decreased extracellular space. As both DWI and FDGPET/CT are functional imaging techniques that are used to evaluate tumor characteristics, one may hypothesize that these two imaging modalities may show a significant correlation. The aim of this study was to evaluate whether there is a correlation between the SUVmax of FDG-PET/CT and ADC values of DWI in musculoskeletal tumors
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