Role of magnetization transfer imaging in bone tumors

Abstract

The authors evaluated the role of magnetization transfer imaging in differentiation of bone tumors, with special emphasis on cartilaginous tumors. Fifty-one patients with skeletal tumors or tumor-like lesions who had undergone magnetic resonance (MR) imaging were included. The tumors were divided into three groups according to their gross appearance and the origin of tissue: cyst, cartilaginous tumor, and noncartilaginous solid tumor. A gradient-recalled acquisition in the steady state sequence was used for MR imaging, and examinations were performed both with and without off-resonance magnetization transfer pulses. Magnetization transfer ratios were obtained as an indicator of magnetization transfer effect of the lesions and were compared. Then, the magnetization transfer ratios of all tumors in the cartilaginous tumor group were compared. The magnetization transfer ratios of benign and malignant solid tumors were also compared. The mean magnetization transfer ratio for cartilaginous tumors was 0.31 +/- 0.08 (standard deviation), and that of cysts and noncartilaginous solid tumors was 0.07 +/- 0.03 and 0.40 +/- 0.14, respectively. Comparisons between the three groups showed statistically significant intergroup differences in magnetization transfer ratio (P < .05). In the cartilaginous tumor category, enchondroma and low-grade chondrosarcoma had a lower magnetization transfer effect than chondroblastoma and mesenchymal chondrosarcoma. The mean magnetization transfer ratios of benign (n = 28) and malignant (n = 18) tumors were 0.35 +/- 0.11 and 0.39 +/- 0.15, respectively; there was no statistically significant intergroup difference (P = .14). Magnetization transfer imaging could be useful for categorizing bone tumors as cysts, cartilaginous tumors, or noncartilaginous solid tumors.