Feasibility study of intra-voxel incoherent motion MR imaging for the differentiation of benign and malignant bone tumors
Ying Li1, Cuiping Ren1, Jingliang Cheng1, and Zhizheng Zhuo2

1First affiliated hospital of Zhengzhou university, Zhengzhou, China, 2Clinical Science, Philips Healthcare, Beijing, China


This work investigated and evaluated the role of intra-voxel incoherent motion(IVIM) MR imaging in characterizing the bone tumors, which might be helpful for clinical diagnosis and studies.


Recent studies have shown that IVIM offers a method to reflect the information of perfusion and diffusion in complex biological tissues in various brain diseases1, liver diseases2, and breast tumors3, but rarely used in the study of bone tumors. The purpose of this study is to investigate the application of IVIM on bone tumors.


73 patients (38 males and 35 females aged 36.8±19.65 years old) with bone tumors (diagnosed according to pathological biopsy) were included in this study. Based on the WHO Classification of Tumors of Soft Tissue and Bone (2012) criteria, 73 patients were divided into two groups: 28 for benign tumors and 45 for malignancies. All the patients were scanned by MR IVIM sequence based on a 3T MR scanner (Ingenia, Philips Healthcare, Best, the Netherlands). The IVIM scanning was performed with 10 b-values of 0, 10, 30, 50, 75, 100, 150, 300, 500, 800s/mm2.The IVIM related parameters of tissue diffusivity (D), pseudo-diffusion coefficient (D* or Dstar) and perfusion fraction (f) were calculated by using a Philips development software (Version 3.0). All the above parameters were measured by drawing ROIs (Region of Interest) within the periphery of the lesions (P_D, P_Dstar, P_f short for periphery D, periphery Dstar, periphery f),the center of the lesions(C_D, C_Dstar, C_f short for center D, center Dstar, center f). And the all the parameters extracted from benign and malignant patients were compared by using Mann-Whitney U test with SPSS software (version 16.0). A P value of less than 0.05 was considered statistically significant.


The results revealed that P_Dstar and P_f value in the lesions are significantly different (P <0.05) between benign and malignant lesions.


IVIM is a non-invasive functional imaging based on diffusion MRI technique, which provide simultaneous evaluation of tumor vascularization and diffusion for the bone tumor characterization. According to IVIM principle, Dstar value and f value are perfusion related parameters, while D value reflect the real water molecule motion. The application of IVIM in other systems has been reported a lot previously, IVIM related parameters shows a good diagnostic efficiency1, and perfusion parameters reflect structure of the microvascular in the tumor. Dstar maps has conformity with the known histologic diagnosis2. Our study results show that P_Dstar and P_f are able to differentiate benign from malignant bone tumors, which suggest that D* and f value provide vascularize information of tumor. This would assist doctors to diagnose the type of the tumor and furtherly was helpful for the corresponding treatment plan for the tumor. In the future, more patients with different types of bone tumors will be included in our study to evaluate clinical value of the IVIM technique and other types of classifiers.


IVIM technique is helpful to evaluate the pathological behavior and provide useful information on the perfusion and diffusion properties related to bone tumors microenvironment.


No acknowledgement found.


[1].VincenzaGranata, Roberta Fusco, Orlando Catalano, et al. Intra-voxel incoherent motion (IVIM) in diffusion-weighted imaging (DWI) for Hepatocellular carcinoma: correlation with histologic grade [J].Oncotarget, 2016,[Epub ahead of print].

[2]. C. Federau, R. Meuli, K. O’Brien, et al. Perfusion Measurement in brain gliomas with intra-voxel incoherent motion MRI [J].Am J Neuroradiol,2014,35: 256-262.

[3]. Jing Yuan1, Oi Lei Wong, Gladys G. Lo, et al. Statistical assessment of bi-exponential diffusion weighted imaging signal characteristics induced by intra-voxel incoherent motion in malignant breast tumors[J]. Quant Imaging Med Surg, 2016, 6(4):418-429.


Figure 1.A patient (male, 62 year old) with a malignant metastatic tumor (white arrow) located at the left proximal tibia and surrounding tissues.

Table 1.The statistical results of the IVIM-derived parameters between benign and malignant bone tumors.

Proc. Intl. Soc. Mag. Reson. Med. 27 (2019)