The Role of Perfusion Magnetic Resonance Imaging in the Discrimination of Benign vs Malign Character of Musculoskeletal Tumors

Abstract

Purpose: There may be difficulties in diagnosing musculoskeletal system tumors with Magnetic Resonance Imaging (MRI). Advanced MRI imaging techniques may contribute to noninvasive diagnosis.The aim of our study was to evaluate the performance of perfusion magnetic resonance imaging quantitative data in the differentiation of benign and malignant musculoskeletal tumors. Material and Methods: Thirty-six histologically proven patients were included in the study retrospectively. All patients underwent 1.5-T perfusion MRI (magnetic resonance imaging) with T1 mapping and diffusion MRI. Four quantitative and one semiquantitative parameter were obtained for each tumor using the Toft pharmacokinetic model. ADCmean and ADCmin values were calculated from apparent diffusion coefficient (ADC) maps. Results: Eighteen of 36 patients (50%) had malignant tumors, and 18 had benign tumors. There were 26 soft tissue tumors and 10 bone tissue tumors. Among malignant and benign tumors, the best performance was found in the Ktrans, Kep, Ve values. (p=0.011, p=0.013, p=0,035). Conclusion: Ktrans and Kep values, which are indicators of increased permeability in the tumor, are noninvasive parameters for determining the malignant character of the tumor. The 'Ve' value is an indicator of the extracellular volume of the tumor. Ktrans, Kep and Ve maps can also guide the biopsy.