A gender difference related to the effect of a background odor: a magnetoencephalographic study.

We measured brain activities with a whole head magnetoencephalograph (MEG) to investigate the influence of a background odor on alphabetical encoding of words in 20 healthy volunteers (10 females). Odor stimulation and control air stimulation were both accomplished with a computer-controlled olfactometer by providing permanent stimulation conditions. Behavioral data revealed significantly prolonged reaction times in men under the influence of phenylethyl alcohol (PEA) compared to the control condition. Women did not show a change in reaction time during stimulation with PEA. A comparison of men and women revealed significantly shorter reaction times in women for both the odor conditions, as well as for the control condition. Analysis of performance accuracy showed no significant differences between the odor and the control condition within and across gender. Analysis of grand averaged, event-related fields and localization of the underlying equivalent current dipoles revealed higher dipole strength in the odor, compared to the control condition in the right hemisphere, over the temporo-parietal brain areas, in the time range between 200 and 500 ms after word-onset only in male subjects. Within this time range, the gender-specific effect is interpreted to reflect odor-related modulation of word processing. The findings suggest gender-specific processing strategies in the present task with implications for differences in hemispheric laterality.

High-resolution CT of transplanted teeth: imaging technique and measurement accuracy.

The aim of this study was to determine the accuracy of crown diameter measurements by dental CT as a tool for preoperative diagnosis before tooth transplantations. Fifty-eight patients underwent clinically indicated dental CT. The diameter of the crowns were measured by CT using a standard protocol (1.5-mm slice thickness, 1-mm table feed, 120 kV, 25-75 mA/s, 2-s scan time/slice, 512 matrix) and a standard dental software package. Postoperatively, the same distances were clinically measured using a sliding gauge. The degree of the deviation between CT measurements and clinical measurements was in the sub-millimeter range. According to the regression analysis, the correlation coefficient equals 0.98 and 0.97, indicating a strong relationship between the CT and the manual measurement of the crown diameter in the bucco-lingual and the mesio-distal direction. The mean deviation of CT measurements with regard to the bucco-lingual diameter of the crown was +0.08 mm (SD: +/-0.38 mm). For the mesio-distal diameter, the mean deviation of CT measurements was -0.24 mm (SD: +/-0.53 mm). These results demonstrate that dental CT promises to be a valuable tool for the evaluation of the potential and optimal size and site for tooth transplantations.

Detection of cutaneous invasion by malignant head and neck tumors with MDCT.

OBJECTIVE: Cutaneous invasion by direct infiltration and metastasis, in malignant head and neck tumors, has a distinct impact on therapeutic options, especially surgical procedures, curative intent, and overall prognosis. Therefore, the purpose of this study was to determine the diagnostic accuracy of MDCT in detecting cutaneous invasion by malignant head and neck tumors. MATERIALS AND METHODS: Nineteen patients with malignant head and neck tumors and clinical suspicion of cutaneous invasion routinely underwent contrast-enhanced 16-row MDCT (Philips MDCT MX 8000) of the region of interest in the axial plane before surgical intervention. The following parameters were used: 16mmx0.75mm detector collimation; 3mm reconstructed slice thickness; 1.5mm increment; 0.75s rotation speed; 120kV, 200mAs; and 100ml non-ionic contrast agent, i.v., with a flow of 2.0ml/s and a scan delay of 50s. The studies were reconstructed with a soft tissue algorithm (W400, L100 HU), and coronal and sagittal planes were also reconstructed. The axial images were retrospectively reviewed in consensus by two radiologists for the evidence of cutaneous invasion blinded to the histological results. The MDCT results were correlated with histology that was obtained by punch biopsy or surgery. RESULTS: MDCT correctly revealed 11 of 11 cases with cutaneous invasion, and correctly excluded 4 of 8 cases without cutaneous invasion. The diagnostic accuracy of MDCT in detecting cutaneous invasion showed a sensitivity of 100%, a specificity of 50%, and an overall accuracy of 79%. CONCLUSION: MDCT reconstructed with a soft tissue algorithm has a good sensitivity and moderate overall accuracy in detecting cutaneous invasion by malignant head and neck tumors.

An automatic model-based system for joint space measurements on hand radiographs: initial experience.

This ethics committee-approved pilot study was performed with informed consent. A Web-based service that was developed for automated measurement of joint space and automatic analysis of radiographs was tested prospectively. A total of 160 metacarpophalangeal joint spaces were measured in 20 patients (average age, 48 years; age range, 18-89 years; 16 women) suspected of having rheumatoid arthritis or osteoarthritis. The technical success rate was 93%. The smallest detectable difference in repeated automatic joint space width measurements varied from 0.08 to 0.31 mm, and the coefficient of variation was 2%-7%. Compared with the reference standard (interactive segmentation of the joint space widths) measurements, results were within a mean error of 0.19-0.40 mm. The proposed Web-based service enables reproducible joint space measurements to be obtained in metacarpophalangeal joints with moderate erosive and osteophytic disease.

Diffusion weighted imaging in osteoradiology.

Diffusion weighted imaging gained attention as an imaging modality, which provides information on the microstructure of a tissue, which can be used for tissue characterization. This is of importance in patients where other diagnostic tools provide equivocal or unspecific information. In addition quantitative diffusion measurements provide objective parameters for unbiased comparison of treatment response, which is mandatory for therapy monitoring. Technical restriction limited the use of Diffusion Weighted Imaging to the brain. However, with the improvement in scanner technology and the availability of new MR sequences investigation of the Muskulo Skeletal System was made possible. We describe the potential of Diffusion Weighted Imaging as a non-invasive technique to evaluate pathological, inflammatory and physiological processes in osteoradiology.

CT-MR image data fusion for computer assisted navigated neurosurgery of temporal bone tumors.

PURPOSE: To demonstrate the value of multi detector computed tomography (MDCT) and magnetic resonance imaging (MRI) in the preoperative work up of temporal bone tumors and to present, especially, CT and MR image fusion for surgical planning and performance in computer assisted navigated neurosurgery of temporal bone tumors. MATERIALS AND METHODS: Fifteen patients with temporal bone tumors underwent MDCT and MRI. MDCT was performed in high-resolution bone window level setting in axial plane. The reconstructed MDCT slice thickness was 0.8 mm. MRI was performed in axial and coronal plane with T2-weighted fast spin-echo (FSE) sequences, un-enhanced and contrast-enhanced T1-weighted spin-echo (SE) sequences, and coronal T1-weighted SE sequences with fat suppression and with 3D T1-weighted gradient-echo (GE) contrast-enhanced sequences in axial plane. The 3D T1-weighted GE sequence had a slice thickness of 1mm. Image data sets of CT and 3D T1-weighted GE sequences were merged utilizing a workstation to create CT-MR fusion images. MDCT and MR images were separately used to depict and characterize lesions. The fusion images were utilized for interventional planning and intraoperative image guidance. The intraoperative accuracy of the navigation unit was measured, defined as the deviation between the same landmark in the navigation image and the patient. RESULTS: Tumorous lesions of bone and soft tissue were well delineated and characterized by CT and MR images. The images played a crucial role in the differentiation of benign and malignant pathologies, which consisted of 13 benign and 2 malignant tumors. The CT-MR fusion images supported the surgeon in preoperative planning and improved surgical performance. The mean intraoperative accuracy of the navigation system was 1.25 mm. CONCLUSION: CT and MRI are essential in the preoperative work up of temporal bone tumors. CT-MR image data fusion presents an accurate tool for planning the correct surgical procedure and is a benefit for the operational results in computer assisted navigated neurosurgery of temporal bone tumors.

MDCT versus digital radiography in the evaluation of bone healing in orthopedic patients.

OBJECTIVE: Assessment of bone healing in orthopedic patients is usually monitored by radiographs in two views. The purpose of our study was to compare multiplanar reconstructions from MDCT data sets with digital radiographs for assessing the extent of bone healing. MATERIALS AND METHODS: Forty-three orthopedic patients (19 women, 24 men) who underwent MDCT and radiography after arthrodesis, fractures, or spinal fusions were included in our study. MDCT was performed on an MX 8000IDT scanner and served as the gold standard. The technical parameters were adapted to the anatomic region. A bone algorithm for reconstruction was used (3,500/600 H). Multiplanar reconstructions were calculated in two orthogonal planes. All patients underwent digital radiography on a Multix FD system in two views according to standard procedures. Multiplanar reconstructions and radiographs were analyzed by two musculoskeletal radiologists in a consensus interpretation to determine bone healing using a semiquantitative approach. RESULTS: In 27 patients (63%), MDCT and digital radiography were concordant with regard to the extent of bone healing, whereas in 16 patients (37%) the results were not concordant. In eight patients (19%) digital radiographs underestimated the extent of bone healing, whereas in another eight patients (19%) they overestimated the degree of fusion. CONCLUSION: MDCT using high-quality 2D reformatting is recommended as the primary imaging technique for the evaluation of bone healing.

Advances in musculoskeletal radiology: multidetector computed tomography.

The clinical potential of multidetector CT is significantly increased because of the possibility of almost instantaneous isotropic reformations in all planes, increased speed and coverage, and easy interpretation. Multidetector CT has a significant role in the correct and quick diagnosis and treatment of emergency department patients. In complex anatomic regions, it is an important diagnostic aid, and it allows exact classification of the bony lesion, which is important for diagnosis, treatment, and prognosis. Multidetector CT visualizes congenital deformities and is useful in oncology. Ongoing developments comprise diagnosis and treatment, preoperative and postoperative planning, and hard-ware imaging. Relatively new but well-known applications of multidetector CT include intraoperative navigation, implant and prosthesis planning and surgery simulation, vertebroplasty, and pedicle screw installations.

White matter hyperintensities and chronicity of depression.

OBJECTIVE: White matter hyperintensities (WMHs) on T(2)-weighted magnetic resonance imaging (MRI) of the brain are associated with advanced age and late-life depression. Most investigations predominantly found these lesions in frontal lobe and basal ganglia supporting the hypothesis of a fronto-striatal dysfunction in depression. A prospective study was undertaken to investigate the association between extent of WMHs and clinical outcome in elderly depressed patients. METHODS: Thirty-one non-demented depressed subjects underwent a 1.5 T cranial MRI scan. The MRI scans were analysed in consensus by two experienced radiologists. Each MRI scan was assessed for presence and extent of WMHs, which are differentiated in periventricular hyperintensities (PVHs) and deep white matter hyperintensities (DWMHs). A total of 21 patients of the original cohort of 31 patients were re-assessed 5 years after baseline assessment. We ascertained the severity of depressive symptoms, the longitudinal course of depression, the cognitive decline and the global assessment of functioning at follow-up visit. RESULTS: (1) Subjects with greater extent of WMHs had a significant higher Hamilton Depression Rating Scale (HAM-D) score, (2) had more severe longitudinal courses of depression (3) and had a lower Mini-Mental State Examination (MMSE) score. CONCLUSIONS: WMHs on MRI are associated with poorer outcome in elderly depressed subjects. Further studies are needed to evaluate WHMs as prognostic factor for an appropriate treatment decision-making.

Olfaction and face encoding in humans: a magnetoencephalographic study.

Magnetic field changes were recorded while 20 healthy young participants performed a deep face encoding task. Some of the faces were randomly associated with a simultaneously presented odor. A recognition test, during which all faces were presented again together with the same number of new faces, followed. The task was to discriminate between repeated and new faces. During the recognition test no odor was presented. The recognition performance was significantly influenced by the simultaneously associated odor during the encoding phase. Faces associated with odor were less accurately recognized. In addition, we found significant physiological differences between 'encoded faces without odor' and 'encoded faces with odor'. In particular, two effects occurred. Between about 200 and 300 ms after stimulus onset 'encoded faces without odor' evoked higher brain activity than 'encoded faces with odor'. Between about 600 and 900 ms after stimulus onset 'encoded faces with odor' evoked higher brain activity than 'encoded faces without odor'. Whereas the latter effect is interpreted as reflecting conscious olfactory information processing, the earlier effect is suggested to reflect an odor influence on face encoding. We suggest that the simultaneous odor association distracted face encoding resulting in a significantly reduced recognition performance. These findings are suggested to represent evidence of multimodal sensoric interactions between visual face processing and olfactory information.

Computer-enhanced stereoscopic vision in a head-mounted operating binocular.

Based on the Varioscope, a commercially available head-mounted operating binocular, we have developed the Varioscope AR, a see through head-mounted display (HMD) for augmented reality visualization that seamlessly fits into the infrastructure of a surgical navigation system. We have assessed the extent to which stereoscopic visualization improves target localization in computer-aided surgery in a phantom study. In order to quantify the depth perception of a user aiming at a given target, we have designed a phantom simulating typical clinical situations in skull base surgery. Sixteen steel spheres were fixed at the base of a bony skull, and several typical craniotomies were applied. After having taken CT scans, the skull was filled with opaque jelly in order to simulate brain tissue. The positions of the spheres were registered using VISIT, a system for computer-aided surgical navigation. Then attempts were made to locate the steel spheres with a bayonet probe through the craniotomies using VISIT and the Varioscope AR as a stereoscopic display device. Localization of targets 4 mm in diameter using stereoscopic vision and additional visual cues indicating target proximity had a success rate (defined as a first-trial hit rate) of 87.5%. Using monoscopic vision and target proximity indication, the success rate was found to be 66.6%. Omission of visual hints on reaching a target yielded a success rate of 79.2% in the stereo case and 56.25% with monoscopic vision. Time requirements for localizing all 16 targets ranged from 7.5 min (stereo, with proximity cues) to 10 min (mono, without proximity cues). Navigation error is primarily governed by the accuracy of registration in the navigation system, whereas the HMD does not appear to influence localization significantly. We conclude that stereo vision is a valuable tool in augmented reality guided interventions.

Dental CT and orthodontic implants: imaging technique and assessment of available bone volume in the hard palate.

PURPOSE: Palatal implants (PI) have been introduced for orthodontic treatment of dental and skeletal dysgnathia. Due to the restricted amount of bone in this region, precise preoperative anatomic information is necessary. The aim of this study was to determine whether dental CT could serve as a tool to locate the optimal size and position for orthodontic implant placement. MATERIALS AND METHODS: In 32 patients, where palatal implant placement was planned, axial CT scans of the maxillary bone were acquired. Using a standard dental software package (Easy Vision dental software package 2.1, Philips; Best, The Netherlands), paracoronal views were reconstructed and measurements of palatal bone height in 3 mm increments, dorsally from the incisive canal, were performed in the median and both paramedian regions. RESULTS: The overall mean bone height was 5.01 mm (S.D. 2.60), ranging from 0 to 16.9 mm. The maximum palatal bone height was 6.17 mm (S.D. 2.81) at 6 mm dorsally from the incisive canal. Due to the lack of adequate bone (less than 4 mm), implant placement was not performed in 3 cases (7%). In the remaining 39 cases (93.0%), primary implant stability was achieved and complications, such as perforation of the palate, could be avoided. CONCLUSION: The results demonstrate that dental CT promises to be a valuable tool in evaluating the potential and optimal size and site for orthodontic implant placement.

Definition of pertinent parameters for the evaluation of articular cartilage repair tissue with high-resolution magnetic resonance imaging.

To evaluate articular cartilage repair tissue after biological cartilage repair, we propose a new technique of non-invasive, high-resolution magnetic resonance imaging (MRI) and define a new classification system. For the definition of pertinent variables the repair tissue of 45 patients treated with three different techniques for cartilage repair (microfracture, autologous osteochondral transplantation, and autologous chondrocyte transplantation) was analyzed 6 and 12 months after the procedure. High-resolution imaging was obtained with a surface phased array coil placed over the knee compartment of interest and adapted sequences were used on a 1 T MRI scanner. The analysis of the repair tissue included the definition and rating of nine pertinent variables: the degree of filling of the defect, the integration to the border zone, the description of the surface and structure, the signal intensity, the status of the subchondral lamina and subchondral bone, the appearance of adhesions and the presence of synovitis. High-resolution MRI, using a surface phased array coil and specific sequences, can be used on every standard 1 or 1.5 T MRI scanner according to the in-house standard protocols for knee imaging in patients who have had cartilage repair procedures without substantially prolonging the total imaging time. The new classification and grading system allows a subtle description and suitable assessment of the articular cartilage repair tissue.

The story of 12 Chachapoyan mummies through multidetector computed tomography.

OBJECTIVE: To assess the imaging findings in Chachapoyan mummies of Peru through multidetector computed tomography (MDCT). MATERIALS AND METHODS: Twelve human mummies and three burial objects from Laguna de los Cóndores, Peru, about 500-1000 years old, were studied, using a MDCT unit. In addition to the standard whole-body acquisitions, high-resolution scans from areas of particular interest were acquired individually (e.g., temporal bone, teeth). RESULTS: Eight mummies were female, three male, and sex was indeterminable in one mummy; the age of the mummies included newborn, 0.7 years, 2.5 years, 13 years, 13 years, 16 years, and six between 20 and 40 years old. The stature of the mummies was reconstructed (mean±standard deviation; adults: 145±14cm, adolescents: 116±17cm, 2.5 years old child: 72cm, newborns: 41±3cm). Dental conditions were compromised in seven and excellent in five mummies. Besides a dislocation of the ossicles, temporal bones and ears were normal in all mummies. An occipital osteoma, a tuberculous spondylodiscitis, and also probable tuberculous erosions at one tarsal joint and one sacral bone, osteoarthritis or tuberculous affection of a sacroiliac joint, as well as five cases of pulmonary tuberculosis were observed. Ten mummies were buried in the fetal position, two were found packaged in bundles; the burial technique was studied in detail. A necklace was found with one mummy. The added burial objects were identified as skeletal parts of two leopardis pardalis and one lagothrix flavicauda. CONCLUSIONS: MDCT non-invasively revealed information about age, sex, stature, diseases, burial practices and other cultural aspects of the Chachapoyas.

MR imaging of the cervical spine: assessment of image quality with parallel imaging compared to non-accelerated MR measurements.

To compare the quality of cervical spine MR images obtained by parallel imaging [generalized autocalibrating partially parallel acquisition (GRAPPA)] with those of non-accelerated imaging, we conducted both phantom studies and examinations of ten volunteers at 1.5Tesla with a dedicated 12-element coil system and a head-spine-neck coil combination. Acquisitions included axial T2-weighted (T2w) images with both methods, and sagittal T2w and T1w images in vivo with the latter coil combination. Non-accelerated MRI with two averages and GRAPPA (acceleration factor 2) with two averages (GRAPPA/2AV, time reduction of approximately 50%) and four averages (GRAPPA/4AV) were compared. In the phantom, the signal-to-noise ratio of the GRAPPA/2AV was lower than that of the other two settings. In vivo, the image inhomogeneity (non-uniformity, NU) was significantly higher in T2w GRAPPA/2AV than in both other settings, and in T1w GRAPPA/2AV compared to GRAPPA/4AV. Subjectively, the delineation of anatomical structures was sufficient in all sequences. Only the spinal cord was considered to be better delineable on the non-accelerated T1w sequence compared to GRAPPA/2AV. In part, GRAPPA/4AV performed better than the other settings. The subjective image noise was lowest with GRAPPA/4AV. In cervical spine MRI, the examination time can be reduced by nearly 42% with GRAPPA, while preserving sufficient image quality.

Brain shape in human microcephalics and Homo floresiensis.

Because the cranial capacity of LB1 (Homo floresiensis) is only 417 cm(3), some workers propose that it represents a microcephalic Homo sapiens rather than a new species. This hypothesis is difficult to assess, however, without a clear understanding of how brain shape of microcephalics compares with that of normal humans. We compare three-dimensional computed tomographic reconstructions of the internal braincases (virtual endocasts that reproduce details of external brain morphology, including cranial capacities and shape) from a sample of 9 microcephalic humans and 10 normal humans. Discriminant and canonical analyses are used to identify two variables that classify normal and microcephalic humans with 100% success. The classification functions classify the virtual endocast from LB1 with normal humans rather than microcephalics. On the other hand, our classification functions classify a pathological H. sapiens specimen that, like LB1, represents an approximately 3-foot-tall adult female and an adult Basuto microcephalic woman that is alleged to have an endocast similar to LB1's with the microcephalic humans. Although microcephaly is genetically and clinically variable, virtual endocasts from our highly heterogeneous sample share similarities in protruding and proportionately large cerebella and relatively narrow, flattened orbital surfaces compared with normal humans. These findings have relevance for hypotheses regarding the genetic substrates of hominin brain evolution and may have medical diagnostic value. Despite LB1's having brain shape features that sort it with normal humans rather than microcephalics, other shape features and its small brain size are consistent with its assignment to a separate species.

Limited diagnostic agreement of quantitative sonography of the radius and phalanges with dual-energy x-ray absorptiometry of the spine, femur, and radius for diagnosis of osteoporosis.

OBJECTIVE: The aim of our study was to evaluate the diagnostic agreement of quantitative sonography of the radius and proximal phalanx and dual-energy X-ray absorptiometry (DXA) of the radius, lumbar spine, and femoral neck for the detection of osteoporosis. MATERIALS AND METHODS: In 95 women (mean age, 53 +/- 13 years) and 26 men (mean age, 53 +/- 13 years), DXA measurements of the lumbar spine (posterior-anterior, L1-L4) and the femoral neck, as well as quantitative sonography of the radius and proximal phalanx of the third finger were obtained. The percentage of patients below a given threshold was calculated for each imaging technique. A T score of less than -2.5 indicated presence of osteoporosis. Diagnostic agreement in identifying individuals with osteoporosis was assessed using kappa scores. RESULTS: Between 14% and 22% of the patients were classified as osteoporotic after DXA of the various regions of interest of the radius, 31% after DXA of the spine, 43% after DXA of the femoral neck, 32% after quantitative sonography of the distal radius, and 34% after quantitative sonography of the phalanx of the third finger. Correlation coefficients between T values for quantitative sonography and those for DXA varied between not significant and 0.54 at the different regions. Kappa analysis showed the diagnostic agreement among quantitative sonography and DXA to be fair to moderate (kappa = 0.38-0.48). The highest agreement was between quantitative sonography of the proximal phalanx of the third finger and DXA of the total radius (kappa 0.48; p < 0.05). CONCLUSION: Considerable diagnostic disagreement exists between quantitative sonography and DXA of the forearm, as is true for most quantitative techniques in the assessment of skeletal status. The lack of correlation makes quantitative sonography impractical for routine diagnostic use but might characterize different parameters related to bone quality.

Guidelines and algorithms: strategies for standardization of referral criteria in diagnostic radiology.

Guidelines can be regarded as special forms of algorithms and have been shown to be useful tools for supporting medical decision making. With the Council Directive 97/43/Euratom recommendations concerning referral criteria for medical exposure have to be implemented into national law of all EU member states. The time- and cost-consuming efforts of developing, implementing, and updating such guidelines are balanced by the acceptance in clinical practice and eventual better health outcomes. Clearly defined objectives with special attention drawn on national and regional differences among potential users, support from organisations with expertise in evidence-based medicine, separated development of the evidence component and the recommendations component, and large-scale strategies for distribution and implementation are necessary. Editors as well as users of guidelines for referral criteria have to be aware which expectations can be met and which cannot be fulfilled with this instrument; thus, dealing with guidelines requires a new form of "diagnostic reasoning" based on medical ethics.

Olfaction and depth of word processing: a magnetoencephalographic study.

Using a whole-cortex magnetoencephalograph, magnetic field changes were recorded to describe brain activities related to simultaneous visual and olfactory processing and to detect odor-related influences on verbal information processing. Words had to be either shallowly (nonsemantic) or deeply (semantic) encoded by healthy young subjects, each of these tasks under two different kinds of olfactory stimulation. After each encoding phase, word recognition performance was tested. First, the odor was randomly associated with some of the study words (simultaneous stimulation; same duration as for words) for both depths of word processing conditions, and second, continuous olfactory stimulation (permanent stimulation) was provided during the whole study phases of both depths of word processing conditions. The statistical analysis of the physiological data revealed evidence of a specific odor-induced effect depending on depth of word processing and kind of olfactory stimulation. Brain activity between about 250 and 450 ms as well as between about 650 and 1000 ms after stimulus onset was found to vary as a function of odor delivery and depth of word processing. In addition, a significant effect of odor stimulation on subsequent word recognition performance occurred in case of simultaneous odor stimulation and semantic word encoding. It is interpreted that in this case, word recognition performance significantly decreased because of the presence of the odor during prior word encoding. Such a behavioral effect was missing in all other conditions. The present psychological and physiological findings support the idea that semantic word encoding is specifically affected by simultaneous olfactory information processing. It is concluded that this phenomenon is due to a competition with cortical regions related to language and olfactory information processing, as suggested by T. S. Lorig (1999, Neurosci. Biobehav. Rev. 23, 391-398).

Vertebral metastases: assessment with apparent diffusion coefficient.

The authors evaluated the apparent diffusion coefficient (ADC) in the assessment of vertebral metastases and acute vertebral compression fractures in 22 patients with known or suspected vertebral metastases. On the basis of significantly (P <.03) different ADCs, vertebral metastases (0.69 x 10(-3) mm2/sec) and pathologic compression fractures (0.65 x 10(-3) mm2/sec) can be safely distinguished from vertebral bodies (1.66 x 10(-3) mm2/sec) and benign compression fractures (1.62 x 10(-3) mm2/sec). Thus, the use of ADCs may increase the specificity of magnetic resonance imaging in these patients.