Value of zero echo time MR imaging and CT in diagnosis of bone destructions of bone tumors and tumor-like lesions

Abstract

Bone tumors and tumor-like lesions require that comprehensive imaging contains soft tissues and bone structures. There are so many kinds of examinations that the patients with bone tumors and tumor-like lesions should be performed. The objective of this study was to demonstrate the clinical applicability of zero echo time (ZTE) magnetic resonance (MR) imaging in osseous bone tumor imaging and evaluate the image quality between computed tomography (CT) and ZTE imaging of bone tumors and tumor-like lesions. Thirty-six patients included 18 male patients (mean age: 35 ± 20 years) and 18 female patients (mean age: 42 ± 20 years) were recruited from a clinical cohort of patients undergoing MR and CT. We presented a novel scanning technique for MR scanners (750 W MR, GE Medical Systems) that could obtain ZTE images. ZTE images were acquired after standard-of-care MR imaging. Quality comparison of osseous findings was performed between ZTE and CT imaging using a five-point grading scale. The differences of image quality between ZTE and CT imaging were investigated using Mann–Whitney test. A significance level of P < 0.05 was used for all statistical analyses. Agreement was assessed between the raters and Weight Kappa statistics were used. Interpretation of agreement was based on published standards: 0.00–0.20 indicated slight; 0.21–0.40, fair; 0.41–0.60, moderate; 0.61–0.80, substantial; and 0.81–1, perfect agreement. There were 13 kinds of bone tumors and tumor-like lesions. The differences of image quality between ZTE (4.47 ± 0.76) and CT (4.97 ± 0.16) imaging were not significant (Z = − 1.83, P = 0.067). It showed good agreement between the two raters (K = 1, K = 0.84) in the bone destruction between CT and ZTE. CT and ZTE-MR had similar displays in lesion’s boundary, periosteal reaction, bone sclerosis, bone destructions, calcifications, and soft tissues. Our results confirm that ZTE-MR imaging provides accurate imaging of bone morphology with CT-like contrast that is not available with the standard MR sequences.