JOURNAL DESCRIPTION
The Medical Radiology and Radiation Safety journal ISSN 1024-6177 was founded in January 1956 (before December 30, 1993 it was entitled Medical Radiology, ISSN 0025-8334). In 2018, the journal received Online ISSN: 2618-9615 and was registered as an electronic online publication in Roskomnadzor on March 29, 2018. It publishes original research articles which cover questions of radiobiology, radiation medicine, radiation safety, radiation therapy, nuclear medicine and scientific reviews. In general the journal has more than 30 headings and it is of interest for specialists working in thefields of medicine¸ radiation biology, epidemiology, medical physics and technology. Since July 01, 2008 the journal has been published by State Research Center - Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency. The founder from 1956 to the present time is the Ministry of Health of the Russian Federation, and from 2008 to the present time is the Federal Medical Biological Agency.
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Medical Radiology and Radiation Safety. 2023. Vol. 68. № 6
DOI:10.33266/1024-6177-2023-68-6-80-85
S.N. Prokhorov1, N.V. Kochergina1, 2, A.D. Ryzhkov1, 2,A.S. Krylov1, A.B. Bludov1
The Apparent Diffusion Coefficient in the Diagnosis of Metastatic Lesions of Skeletal Bones
1 N.N. Blokhin National Medical Research Center of Oncology, Moscow, Russia
2 Russian Medical Academy of Continuous Professional Education, Moscow, Russia
Contact person: Sergei Nikolaevich Prokhorov, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
Abstract
Aim: To evaluate the possibilities of absolute and relative values of the apparent diffusion coefficient (ADC) in the diagnosis of metastatic lesions of skeletal bones.
Material and methods: The study included 12 patients with metastatic bone lesions, before any treatment was applied. The age of the patients ranged from 38 to 73 years, 3 men, 9 women. Among the morphological forms of tumors were presented: cancers of the breast (3), prostate (1) glands, colon (1), lung (2), body (1) and cervix (1) uterus, thyroid (1) and pancreas (2). The detected changes were classified on the basis of Bone scan, SPECT/CT and standard MRI. The ADC values of unchanged bone marrow (n=360), divided by anatomical zones, metastatic foci (n=117), as well as benign changes of various nature (n=19) were analyzed. The ratio of the ADC values of each of the metastatic and benign focal formations to the normal values for each of the localizations was calculated.
Results: Unchanged bone marrow, depending on anatomical localization (cervical, thoracic, lumbar spine, pelvic bones, shoulder blades, collarbones, sternum, ribs, proximal humerus and femur bones) from the point of view of ADC, showed statistically significant heterogeneity. Statistical analysis has shown that there is no connection between the groups of ADC indicators in the foci of metastatic lesions, combined depending on the anatomical localization. With a similar comparison, but by belonging to the primary tumor, an even greater intergroup difference was found. ADC values in the foci of metastatic lesions turned out to be dependent on the morphological type of the primary tumor and significantly differ both from metastases of other morphological affiliation and from normal red bone marrow parameters. The use of relative values allowed to increase the specificity from 15 to 19 %.
Conclusion: This study showed that knowledge of the range of reference ADC values for unchanged red bone marrow and anomalies of various genesis is important in differential diagnosis. The differentiation of the skeleton into separate anatomical zones probably makes it possible to increase the effectiveness of the isolated application of the technique when it comes to absolute values. The morphological affiliation of metastatic foci is important in the formation of ADC values, rather than the bone marrow microenvironment, which is also supported by the low efficiency of the use of relative values.
Keywords: bone metastases, MRI, apparent diffusion coefficient, SPECT/CT, bone scan
For citation: Prokhorov SN, Kochergina NV, Ryzhkov AD, Krylov AS, Bludov AB. The Apparent Diffusion Coefficient in the Diagnosis of Metastatic Lesions of Skeletal Bones. Medical Radiology and Radiation Safety. 2023;68(6):80–85. (In Russian). DOI:10.33266/1024-6177-2023-68-6-80-85
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PDF (RUS) Full-text article (in Russian)
Conflict of interest. The authors declare no conflict of interest.
Financing. The study had no sponsorship.
Contribution. Article was prepared with equal participation of the authors.
Article received: 20.07.2023. Accepted for publication: 27.08.2023.