The value of added opposed/in phase MRI sequences in characterization of the focal vertebral bone marrow lesions in oncology patients

Objective: This study aimed to evaluate the value of added opposed/in phase MRI sequences with signal intensity ratio (SIR) calculations in differentiation malignant and benign vertebral focal marrow lesions in oncology patients. Patients and methods: From January 2013 to December 2014, a total of 50 oncology patients with 63 focal spinal bone marrow lesions underwent MRI examination with added opposed/in-phase sequences. A computation of SIR of the marrow on the opposed phase to signal intensity measured on the in-phase images was made. Results: The examined 50 oncology patients showed 63 focal lesions, 39 proved to be malignant and 24 diagnosed as benign. The majority of malignant lesions (32/39) showed persistence of the high signals at the opposed phase sequences while signal loss was noted on all benign lesions. SIR values were ranged between 1.1 and 2.6 in malignant lesions while it ranged from 0.47 to 0.9 in benign lesions; when a SIR of 1 as a cutoff was chosen, it showed high sensitivity and specificity (96.8% and 93.65% respectively). Conclusion: The added opposed/in phase MRI sequences with SIR cut-off value of 1, were proved to be a non-invasive sensitive tool to differentiate between malignant and benign lesions in oncology patients