ArticleEuropean radiology2018
Proton density fat fraction (PDFF) MRI for differentiation of benign and malignant vertebral lesions.
Article in European radiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.
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Who cites it
28 citing papers in PubMed, 50 citations in OpenAlex.
- Development and internal validation of a noninvasive predictive model based on iron and fat measurements for pathologic risk stratification in prostate cancer.Translational andrology and urology · 2026Article
- Simultaneous Water-Specific and Fat-Specific T1 and Fat Fraction Mapping of the Abdomen in Free Breathing Conditions With a Radially Encoded MP2RAGE.NMR in biomedicine · 2026Article
- Influence of imaging method on fat fraction estimation for assessing bone marrow in metastatic prostate cancer.European radiology · 2025Article
- How I Do It: MRI of the Bone with Marrow-specific Sequences.Radiology · 2025Review
- Proton Density Fat Fraction Micro-MRI for Non-Invasive Quantification of Bone Marrow Aging and Radiation Effects in Mice.Bioengineering (Basel, Switzerland) · 2025Article
- Improved MRI detection of inflammation-induced changes in bone marrow microstructure in mice: a machine learning-enhanced T2 distribution analysis.European radiology experimental · 2025Article
- Exploring Fat Fraction and Vertebral Bone Quality Score in Lumbar Spine Magnetic Resonance Imaging: A Cross-Sectional Study on Associations and Clinical Implication.Diagnostics (Basel, Switzerland) · 2025Article
- Bone metastases from endocrine cancer: advances in diagnosis, treatment, and prevention.Frontiers in endocrinology · 2025Review
- Understanding ADC variation by fat content effect using a dual-function MRI phantom.European radiology experimental · 2024Article
- Quantitative biomarkers for distinguishing bone metastasis and benign bone marrow lesions using turbo spin echo T1- and T2-weighted Dixon imaging at 3.0 T.European journal of radiology open · 2023Article
- MRI fat fraction imaging of nodal and bone metastases in prostate cancer.European radiology · 2023Article
- Preliminary study for prediction of benign vertebral compression fracture age by quantitative water fraction using modified Dixon sequences: an imaging biomarker of fracture age.La Radiologia medica · 2023Article
- T2*-corrected Q-Dixon and reduced-FOV diffusion kurtosis imaging (DKI) parameters: correlation with QCT-derived bone mineral density (BMD) and ability to identify abnormal BMD and osteoporosis in postmenopausal women.Quantitative imaging in medicine and surgery · 2023Article
- Feasibility Study of 3D FACT and IVIM Sequences in the Evaluation of Female Osteoporosis.Bioengineering (Basel, Switzerland) · 2023Article
- Advances in Bone Marrow Imaging: Strengths and Limitations from a Clinical Perspective.Seminars in musculoskeletal radiology · 2023Article
- Quantitative Dixon and intravoxel incoherent motion diffusion magnetic resonance imaging parameters in lumbar vertebrae for differentiating aplastic anemia and acute myeloid leukemia.Frontiers in oncology · 2023Article
- Differentiation of bone metastases from benign red marrow depositions of the spine: the role of fat-suppressed T2-weighted imaging compared to fat fraction map.European radiology · 2022Article
- Assessing the ADC of Bone-marrow on Whole-body MR Images in Relation to the Fat-suppression Method and Fat Content.Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine · 2022Article
- MR-based proton density fat fraction (PDFF) of the vertebral bone marrow differentiates between patients with and without osteoporotic vertebral fractures.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2022Article
- Finite Element Analysis of Osteoporotic and Osteoblastic Vertebrae and Its Association With the Proton Density Fat Fraction From Chemical Shift Encoding-Based Water-Fat MRI - A Preliminary Study.Frontiers in endocrinology · 2022Article
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Authors and funding
11 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo investigate whether proton density fat fraction (PDFF) measurements using a six-echo modified Dixon sequence can help to differentiate between benign and malignant vertebral bone marrow lesions.
methodsSixty-six patients were prospectively enrolled in our study. In addition to conventional MRI at 3.0-Tesla including at least sagittal T2-weighted/spectral attenuated inversion recovery and T1-weighted sequences, all patients underwent a sagittal six-echo modified Dixon sequence of the spine. The mean PDFF was calculated using regions of interest and compared between vertebral lesions. A cut-off value of 6.40% in PDFF was determined by receiver operating characteristic curves and used to differentiate between malignant (< 6.40%) and benign (≥ 6.40%) vertebral lesions.
resultsThere were 77 benign and 44 malignant lesions. The PDFF of malignant lesions was statistically significant lower in comparison with benign lesions (p < 0.001) and normal vertebral bone marrow (p < 0.001). The areas under the curves (AUC) were 0.97 for differentiating benign from malignant lesions (p < 0.001) and 0.95 for differentiating acute vertebral fractures from malignant lesions (p < 0.001). This yielded a diagnostic accuracy of 96% in the differentiation of both benign lesions and acute vertebral fractures from malignancy.
conclusionPDFF derived from six-echo modified Dixon allows for differentiation between benign and malignant vertebral lesions with a high diagnostic accuracy. KEY POINTS: • Establishing a diagnosis of indeterminate vertebral lesions is a common clinical problem • Benign bone marrow processes may mimic the signal alterations observed in malignancy • PDFF differentiates between benign and malignant lesions with a high diagnostic accuracy • PDFF of non-neoplastic vertebral lesions is significantly higher than that of malignancy • PDFF from six-echo modified Dixon may help avoid potentially harmful bone biopsy.
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