Evaluation of benign and malignant vertebral lesions with diffusion weighted magnetic resonance imaging and apparent diffusion coefficient measurements

Aim of the work The aim of this study was to assess the utility of apparent diffusion coefficient obtained in diffusion-weighted MR imaging for the differentiation between benign and malignant vertebral lesions, and to determine the sensitivity and the specificity in differentiating benign and malignant vertebral lesions according to the optimal cutoff ADC value. Patients and methods In 50 patients, 96 vertebral lesions were included and underwent DW MR Imaging. The mean ADC values of normal and abnormal vertebrae were calculated. The optimal cutoff ADC value was determined for the differentiation of benign and malignant lesions. The results were correlated with histopathological and surgical findings. Results The mean ADC value of benign lesions was significantly higher than that of malignant ones (P < 0.05). There was an overlap between the mean ADC values of malignant and tuberculous lesions. According to the optimal cutoff value of 1.21 × 10-3 mm2/s, determined for the differentiation of benign and malignant vertebral lesions, sensitivity was 95.12%, specificity 92.73%, positive predictive value 90.70%, and negative predictive value 96.23%. Conclusion Vertebral lesions were differentiated as benign or malignant with high sensitivity and specificity with the aid of ADC values calculated from maps obtained by DWI.