Comparison of the diagnostic accuracy of diffusion-weighted and dynamic contrast-enhanced MRI with 18F-FDG PET/CT to differentiate osteomyelitis from Charcot neuro-osteoarthropathy in diabetic foot
Copyright © 2020 Elsevier B.V. All rights reserved..
PURPOSE: To compare the diagnostic accuracy of diffusion-weighted imaging (DWI) and dynamic contrast-enhanced-magnetic resonance imaging (DCE-MRI) involving two region of interest (ROI) sizes with 18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) to differentiate diabetic foot osteomyelitis (DFO) from Charcot neuro-osteoarthropathy (CN).
METHOD: Thirty-one diabetic patients were included in this prospective study. Two readers independently evaluated DWI (apparent diffusion coefficient [ADC] and high-b-value signal pathological-to-normal bone ratio [DWIr]) and DCE-MRI parameters (Ktrans, Kep, Ve, internal area under the gadolinium curve at 60 s [iAUC60] and time intensity curve [TIC]) using two different ROI sizes, and 18F-FDG PET/CT parameters (visual assessment, SUVmax, delayed SUVmax, and percentage changes between SUVmax and delayed SUVmax). Techniques were compared by univariate analysis using the area under the receiver operating characteristic curve [AUC]. Reliability was analyzed with Kappa and Intraclass correlation [ICC].
RESULTS: DWIr, Ktrans and iAUC60 showed better diagnostic accuracy (AUC = 0.814-0.830) and reliability (ICC > 0.9) for large than for small ROIs (AUC = 0.736-0.750; ICC = 0.6 in Ktrans, 0.8 in DWIr and iAUC60). TIC showed moderate diagnostic performance (AUC = 0.739-0.761) and reliability (κ 0.7). Visual assessment of 18F-FDG PET/CT demonstrated a significantly higher accuracy (AUC = 0.924) than MRI parameters. Semi-quantitative 18F-FDG PET/CT parameters did not provide significant improvement over visual analysis (AUC = 0.848-0.903).
CONCLUSION: DWIr, Ktrans and iAUC60 allowed reliable differentiation of DFO and CN, particularly for large ROIs. Visual assessment of 18F-FDG PET/CT was the most accurate technique for differentiation.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:132 |
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| Enthalten in: |
European journal of radiology - 132(2020) vom: 15. Nov., Seite 109299 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Diez, Ana I Garcia [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 14.04.2021 Date Revised 14.04.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.ejrad.2020.109299 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM316022438 |
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| 100 | 1 | |a Diez, Ana I Garcia |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Comparison of the diagnostic accuracy of diffusion-weighted and dynamic contrast-enhanced MRI with 18F-FDG PET/CT to differentiate osteomyelitis from Charcot neuro-osteoarthropathy in diabetic foot |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
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| 500 | |a Date Completed 14.04.2021 | ||
| 500 | |a Date Revised 14.04.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2020 Elsevier B.V. All rights reserved. | ||
| 520 | |a PURPOSE: To compare the diagnostic accuracy of diffusion-weighted imaging (DWI) and dynamic contrast-enhanced-magnetic resonance imaging (DCE-MRI) involving two region of interest (ROI) sizes with 18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) to differentiate diabetic foot osteomyelitis (DFO) from Charcot neuro-osteoarthropathy (CN) | ||
| 520 | |a METHOD: Thirty-one diabetic patients were included in this prospective study. Two readers independently evaluated DWI (apparent diffusion coefficient [ADC] and high-b-value signal pathological-to-normal bone ratio [DWIr]) and DCE-MRI parameters (Ktrans, Kep, Ve, internal area under the gadolinium curve at 60 s [iAUC60] and time intensity curve [TIC]) using two different ROI sizes, and 18F-FDG PET/CT parameters (visual assessment, SUVmax, delayed SUVmax, and percentage changes between SUVmax and delayed SUVmax). Techniques were compared by univariate analysis using the area under the receiver operating characteristic curve [AUC]. Reliability was analyzed with Kappa and Intraclass correlation [ICC] | ||
| 520 | |a RESULTS: DWIr, Ktrans and iAUC60 showed better diagnostic accuracy (AUC = 0.814-0.830) and reliability (ICC > 0.9) for large than for small ROIs (AUC = 0.736-0.750; ICC = 0.6 in Ktrans, 0.8 in DWIr and iAUC60). TIC showed moderate diagnostic performance (AUC = 0.739-0.761) and reliability (κ 0.7). Visual assessment of 18F-FDG PET/CT demonstrated a significantly higher accuracy (AUC = 0.924) than MRI parameters. Semi-quantitative 18F-FDG PET/CT parameters did not provide significant improvement over visual analysis (AUC = 0.848-0.903) | ||
| 520 | |a CONCLUSION: DWIr, Ktrans and iAUC60 allowed reliable differentiation of DFO and CN, particularly for large ROIs. Visual assessment of 18F-FDG PET/CT was the most accurate technique for differentiation | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Charcot neuro-osteoarthropathy | |
| 650 | 4 | |a Diabetic | |
| 650 | 4 | |a Diffusion-weighted imaging | |
| 650 | 4 | |a Dynamic contrast-enhanced magnetic resonance imaging | |
| 650 | 4 | |a Foot | |
| 650 | 4 | |a Osteomyelitis | |
| 650 | 4 | |a Positron emission tomography computed tomography | |
| 650 | 7 | |a Radiopharmaceuticals |2 NLM | |
| 650 | 7 | |a Fluorodeoxyglucose F18 |2 NLM | |
| 650 | 7 | |a 0Z5B2CJX4D |2 NLM | |
| 700 | 1 | |a Fuster, David |e verfasserin |4 aut | |
| 700 | 1 | |a Morata, Laura |e verfasserin |4 aut | |
| 700 | 1 | |a Torres, Ferran |e verfasserin |4 aut | |
| 700 | 1 | |a Garcia, Ruben |e verfasserin |4 aut | |
| 700 | 1 | |a Poggio, Daniel |e verfasserin |4 aut | |
| 700 | 1 | |a Sotes, Santiago |e verfasserin |4 aut | |
| 700 | 1 | |a Del Amo, Montserrat |e verfasserin |4 aut | |
| 700 | 1 | |a Isern-Kebschull, Jaime |e verfasserin |4 aut | |
| 700 | 1 | |a Pomes, Jaume |e verfasserin |4 aut | |
| 700 | 1 | |a Soriano, Alex |e verfasserin |4 aut | |
| 700 | 1 | |a Brugnara, Laura |e verfasserin |4 aut | |
| 700 | 1 | |a Tomas, Xavier |e verfasserin |4 aut | |
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