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Preliminary study of monoexponential, biexponential, and stretched-exponential models of diffusion-weighted MRI and diffusion kurtosis imaging on differential diagnosis of spinal metastases and chordoma

Abstract

Purpose

Quantitative comparison of diffusion parameters from various models of diffusion-weighted (DWI) and diffusion kurtosis (DKI) imaging for distinguishing spinal metastases and chordomas.

Methods

DWI and DKI examinations were performed in 31 and 13 cases of spinal metastases and chordomas, respectively. DWI derived apparent diffusion coefficient (ADC), true diffusion coefficient (D), pseudo diffusion coefficient (D*), perfusion fraction (f), water molecular distributed diffusion coefficient (DDC), and intravoxel water diffusion heterogeneity (α). DKI derived mean diffusivity (MD) and mean kurtosis (MK). Independent sample t-testing compared statistical differences among parameters. Sensitivity, specificity, and area under the receiver operating characteristic (ROC) curve were determined. Pearson correlation analysis evaluated the parameters’ correlations.

Results

ADC, D, f, DDC, α, and MD were significantly lower in spinal metastases than chordomas (all P < 0.05). MK was significantly higher in spinal metastases than chordomas (P < 0.05). D had the highest area under the ROC curve (AUC) of 0.886, greater than MD (AUC = 0.706) or DDC (AUC = 0.742) in differentiating the two tumors (both P < 0.05). Combining D with f and α statistically significantly increased the AUC for diagnosis (to 0.995) relative to D alone (P < 0.05). There was a certain correlation among DDC, ADC, and D (all P < 0.05).

Conclusions

Monoexponential, biexponential, and stretched-exponential models of DWI and DKI can potentially differentiate spinal metastases and chordomas. D combined with f and α performed best.

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Acknowledgements

This study has received funding by National Natural Science Foundation of China (No. 81971578, No.81701648) and Clinical Key Project of Peking University Third Hospital (BYSY2018007).

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Correspondence to Ning Lang.

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Zhang, J., Xing, X., Wang, Q. et al. Preliminary study of monoexponential, biexponential, and stretched-exponential models of diffusion-weighted MRI and diffusion kurtosis imaging on differential diagnosis of spinal metastases and chordoma. Eur Spine J (2022). https://doi.org/10.1007/s00586-022-07269-w

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  • DOI: https://doi.org/10.1007/s00586-022-07269-w

Keywords

  • Diffusion magnetic resonance imaging
  • Spine
  • Area under curve
  • Sensitivity and specificity