Apparent diffusion coefficient (ADC): A potential in vivo biological surrogate of the incidentally discovered bone lesions at 3T MRI

M R Nouh; Ahmed Doweidar; Abdullah Mohie-Eddin Khalil

doi:10.1016/j.ejro.2021.100386

Apparent diffusion coefficient (ADC): A potential in vivo biological surrogate of the incidentally discovered bone lesions at 3T MRI

Eur J Radiol Open. 2021 Nov 25:8:100386. doi: 10.1016/j.ejro.2021.100386. eCollection 2021.

Authors

M R Nouh¹, Ahmed Doweidar², Abdullah Mohie-Eddin Khalil³

Affiliations

¹ Department of Radiology, Faculty of Medicine, Alexandria University, Egypt.
² Department of Radiology, SWBH NHS TRUST, Birmingham, West Midlands B187QH, UK.
³ Department of Radiology and Clinical Imaging, El-Razi Hospital, Gamal Abd El-Nasser Street, Sulibakhat, 13001 Kuwait City, Kuwait.

Abstract

Purpose: To probe the potential of apparent diffusion coefficient (ADC) to rectify the incidentally detected bone lesion on MRI into benign or malignant lesions.

Materials and methods: We retrospectively recruited 44 patients (24 males and 20 females); with 52 bone lesions, who underwent diffusion weighted (DW) imaging using multiple b-values on 3 T MRI. ADC maps were derived and analyzed by two radiologists; blinded to the final diagnosis. The mean ADC values were used for statistical analyses. The diagnosis was deduced by histopathological confirmation; in 32 lesions and strict clinical and imaging follow-up for at least 12 months; in 20 lesions.

Results: The mean ADC value (mean±SD) of all malignant tumors (including cartilaginous neoplasms) was [0.92 ± 0.40] × 10-3 mm²/s. This significantly differed from those of both primary benign tumors [1.14 ± 0.24] × 10-3 mm²/s, (p = 0.011), and all non-malignant lesions collectively [1.29 ± 0.44] × 10-3 mm²/s, (p < 0.001). Using mADC value of ≤ 1.1 × 10-³ mm²/s resulted in 86.1% sensitivity and 62.5% speciﬁcity for characterizing a lesion as a malignant. The inter-rater reliability was almost perfect (95% CI = 0.954-0.985).

Conclusion: ADC could be a non-invasive in-vivo surrogate that may be able to discern the incidentally discovered osseous lesions into benign and malignant pathologies and guide further diagnostic workup.

Keywords: 3 Tesla (3T); Apparent diffusion co-efficient (ADC) magnetic resonance imaging (MRI); Bone lesions; Diffusion-weighted (DW).