Vertebral Body Compression Fracture: Discriminating Benign from Malignant Causes by Diffusion-Weighted MR Imaging and Apparent Diffusion Coefficient Value
Suwimon Wonglaksanapimon MD*, Orasa Chawalparit MD*, Sutiporn Khumpunnip MD*, Siri-on Tritrakarn MD*, Pipat Chiewvit MD*, Panida Charnchaowanish BSc*
Affiliation : * Department of Radiology, Siriraj Hospital, Mahidol University, Bangkok, Thailand
Objective : To evaluate the diagnostic performance of apparent diffusion coefficient (ADC) value in discriminating benign
from malignant vertebral compression fracture.
Material and Method: 22 symptomatic patients with compression fracture of vertebra referred for conventional MRI spines
during January 2009-March 2010 underwent additional diffusion weighted MR techniques. Evaluation of diffusion weighted
MR imaging and quantified ADC value from reconstructed ADC map were performed. The accuracy, sensitivity, specificity,
positive predictive value and negative predictive value of apparent diffusion coefficient (ADC) value were calculated.
Results : A total of 39 vertebral fractures; 7 malignant compression fractures and 32 benign compression fractures were
evaluated. The difference between ADC values of malignant, benign compression fracture and normal vertebrae were
statistically significant (p < 0.0001). The accuracy, sensitivity and specificity were 89.7%, 85.7% and 90.6% respectively with
the ADC threshold of 0.89 to discriminate malignancy.
Conclusion : The ADC promises to be an effective implement for characterization of vertebral body compression fracture in
differentiating benign and malignant compression fractures.
Keywords : Vertebral body, Compression fracture, Diffusion weighted, ADC value
