ABSTRACT
PURPOSE: To evaluate the role of diffusion-weighted apparent diffusion coefficient (ADC) and in-phase/opposed-phase sequences in the differentiation of benign and malignant osseous tumors. MATERIALS AND METHODS: At 1.5T, routine sequences were compared to diffusion-weighted and in-phase/opposed-phase in 63 patients. Routine sequence magnetic resonance imaging (MRI) scoring, mean ADC value, and in-phase/opposed-phase signal intensity ratio (SIR) was obtained. Statistical analysis included significance, receiver operating characteristic (ROC), and linear correlation between the three parameters. RESULTS: In all, 38 patients had malignant tumors and 25 patients had benign tumors. Benign and malignant tumors showed different routine sequence scores (P < 0.001). Mean ADC of the benign lesions ranged 0.9-3.2 × 10(-3) mm(2) /sec of mean ± SD (1.9 ± 0.6). In malignant tumors, the mean ADC ranged 0.6-1.9 × 10(-3) mm(2) /sec of mean ± SD (1.1 ± 0.4) (P < 0.0001). There was a possible differentiation between malignant and benign tumors at a threshold of 1.1 × 10(-3) mm(2) /sec of sensitivity and specificity of 94.1% and 70.3%, respectively. SIR for benign tumors ranged 0.2-1.0 of mean ± SD (0.6 ± 0.3). For malignant lesions SIR ranged 0.4-1.2 of mean ± SD (0.8 ± 0.3). Benign and malignant tumors show statistically significant SIR at P < 0.022 with possible differentiation at a threshold of 0.75 of sensitivity and specificity of 70.3% and 76.5%, respectively. Simple linear correlation between both ADC and SIR was significant at P < 0.01 with correlation coefficient (r) = 0.45. CONCLUSION: Diffusion-weighted and in-phase/opposed-phase imaging might be used in addition to conventional MRI as a routine tool for differentiation of benign and malignant tumors. J. Magn. Reson. Imaging 2016;44:565-572.
Subject(s)
Algorithms , Bone Neoplasms/diagnostic imaging , Bone Neoplasms/pathology , Diffusion Magnetic Resonance Imaging/methods , Image Interpretation, Computer-Assisted/methods , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Image Enhancement/methods , Male , Middle Aged , Reproducibility of Results , Sensitivity and Specificity , Signal Processing, Computer-Assisted , Young AdultABSTRACT
The application of hydroxyapatite (HA)-based templates is quite often seen in bone tissue engineering since that HA is an osteoconductive bioceramic material, which mimics the inorganic component of mineralized tissues. However, the reported osteoconductivity varies in vitro and in vivo, and the levels of calcium (Ca) release most favorable to osteoconduction have yet to be determined. In this study, HA-based templates were fabricated by melt-extrusion 3D-printing and characterized in order to determine a possible correlation between Ca release and osteoconduction. The HA-based templates were blended with poly(lactide-co-trimethylene carbonate) (PLATMC) at three different HA ratios: 10, 30, and 50%. The printability and physical properties of the HA templates were compared with those of pristine PLATMC. In vitro, osteoconductivity was assessed using seeded human bone marrow-derived mesenchymal stem cells. A mild rate of Ca release was observed for HA10 templates, which exhibited higher mineralized extracellular matrix (ECM) secretion than PLATMC at 14 and 21 days. In contrast, the high rate of Ca release exhibited by HA30 and HA50 templates was associated with reduced osteoconduction and impeded mineralized ECM secretion in vitro. Similar results were observed in vivo. In the calvarial defect model in rabbit, PLATMC and HA10 templates exhibited the highest amount of new bone formation, with obvious contact osteogenesis on their surfaces. In contrast, HA30 and HA50 exhibited distant osteogenesis and reduced amounts of new bone ingrowth. It is concluded that HA-based templates are osteoconductive only at low rates of Ca release.