Comprehensive Review of the Utility of Dynamic Contrast-Enhanced MRI for the Diagnosis and Treatment Assessment of Spinal Benign and Malignant Osseous Disease

Atin Saha, Haley Gibbs, Kyung K. Peck, Onur Yildirim, Parsa Nilchian, Sasan Karimi, Eric Lis, Vilma Kosović and Andrei I. Holodny

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SUMMARY:

Conventional MRI is currently the preferred imaging technique for detection and evaluation of malignant spinal lesions. However, this technique is limited in its ability to assess tumor viability. Unlike conventional MRI, dynamic contrast-enhanced (DCE) MRI provides insight into the physiologic and hemodynamic characteristics of malignant spinal tumors and has been utilized in different types of spinal diseases. DCE has been shown to be especially useful in the cancer setting; specifically, DCE can discriminate between malignant and benign vertebral compression fractures as well as between atypical hemangiomas and metastases. DCE has also been shown to differentiate between different types of metastases. Furthermore, DCE can be useful in the assessment of radiation therapy for spinal metastases, including the prediction of tumor recurrence. This review considers data analysis methods utilized in prior studies of DCE-MRI data acquisition and clinical implications.

ABBREVIATIONS:

AIF
arterial input function
AUC
area under the curve
DCE
dynamic contrast-enhanced
EES
extravascular extracellular space
HD-IGRT
high-dose image-guided radiation therapy
Kep
exchange rate constant
Ktrans
permeability constant
PD
progressive disease
SCI
spinal cord injury
SPGR
spoiled gradient recalled
TIC
time intensity curve
Ve
extracellular volume fraction
Vp
plasma volume
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