Value of Perfusion and Permeability Measurements in Distinguishing Between Benign and Malignant Vertebral Lesions

Andreas Biffar¹, Gerwin Schmidt², Steven Sourbron¹, Olaf Dietrich¹, Maximilian Reiser², Andrea Baur-Melnyk²

Benign and malignant lesions of vertebral bodies modify their vascular structure and supply. Previous studies of dynamic contrast-enhanced MRI (DCE-MRI) in vertebral bone marrow, trying to assess these changes, were based on descriptive perfusion indices. These suffer from well-known limitations, like dependence on experimental variables and an ill-defined relation to hemodynamic parameters. To solve these problems, we performed a quantitative analysis using a two-compartment model, allowing for the separate determination of perfusion and permeability. Perfusion parameters were determined in patients with benign and malignant vertebral compression fractures. Perfusion indices might have the potential to distinguish between osteoporotic and pathological fractures.