Chemical shift Dixon MR imaging to differentiate benign and malignant bone marrow lesions: A cross-sectional study.
DOI:
https://doi.org/10.51168/sjhrafrica.v7i2.2705Keywords:
Chemical shift, Bone marrow lesions, In phase, Out of phaseAbstract
Background:
Bone lesions encompass a wide spectrum of abnormalities ranging from benign growths, such as osteochondromas and enchondromas, to malignant tumors like osteosarcomas and Ewing’s sarcomas.
Objective:
To quantify the percentage signal loss in bone marrow lesions resulting from replacement of the fatty marrow component by neoplastic tissue, to differentiate benign from malignant bone lesions.
Methods:
A total of 100 patients with bone lesions were included in this study. Patients of any age group presenting with bone tumors underwent an MRI scan in MR Omega (3 Tesla). The patients were thoroughly counselled, and no contrast agents were used. The % SI drop was calculated as follows: % SI drop = [(SIIP – SIOOP)/SIIP] × 100 (IP-In phase and OOP- Out of phase).
Results:
Most patients were male (62%). The mean age of the patients was 45.4 years. The majority of the patients had <20% signal intensity drop (54%). At a 20% drop in signal intensity, malignant and benign lesions had sensitivities of 80% and 85%; specificities of 85% and 88.9%; PPVs of 73.9% and 88.9%; NPVs of 82% and 73.9%; and accuracies of 82% and 82%.
Conclusion:
To describe localized and diffuse marrow abnormalities on standard non-contrast imaging, chemical shift imaging is a helpful supplementary magnetic resonance imaging approach. When it comes to detecting cancerous diseases, it is quite sensitive. In almost 46% of individuals with benign illness, a biopsy might be avoided despite its reduced specificity.
Recommendation:
Larger-scale studies across a wider range of bone marrow lesions to better quantify the percentage signal loss and assess the broader applicability of this MRI technique in clinical practice.
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Copyright (c) 2026 Shuvam Ghosh, Santosh Kumar Padhy, Sibani Patro, Maheswar Chaudhury
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