| Research Synthesis: What is the Diagnostic Performance of MRI to Discriminate Benign from Malignant Vertebral Compression Fractures? Systematic Review and Meta-Analysis. | |
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MedLine Citation:
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PMID: 22210011 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Study Design. This study is a research synthesis of the published literature evaluating the performance of Magnetic Resonance Imaging (MRI) for differentiation of malignant from benign vertebral compression fracture (VCF).Objective. Perform a systematic review and meta-analysis to summarize and combine the published data on MRI for discriminating malignant from benign VCF.Summary of Background Data. The differentiation between benign and malignant VCF in the spine is a challenging problem confronting spine practitioners.Methods. MEDLINE, EMBASE and other databases were searched by two independent reviewers to identify studies that reported the performance of MRI for discriminating malignant from benign VCF. Included studies were assessed for described MRI features and study quality. The sensitivity, specificity, and diagnostic odds ratio (OR) of each feature were pooled with a random effects model weighted by the inverse of the variance of each individual estimate.Results. 31 studies with 1685 subjects met the selection criteria. All the studies focused on describing specific features rather than overall diagnostic performance. Signal intensity ratio on opposed phase (chemical shift) imaging ≥ 0.8(OR = 164), apparent diffusion coefficient on echo planar diffusion-weighted images ≤ 1.5×10-3 mm/sec with b-value 500s/mm(OR = 130), presence of other non-characteristic vertebral lesions(OR = 55), presence of paraspinal mass(OR = 33), involvement of posterior element(OR = 28), involvement of pedicle(OR = 24), complete replacement of normal bone marrow in VCF(OR = 19), presence of epidural mass(OR = 13) and diffuse convexity of posterior vertebral border(OR = 10) were associated with malignant VCFs whereas co-existing healed benign VCF(OR = 0.006), presence of fluid sign(OR = 0.08), presence of focal posterior vertebral border convexity/retropulsion(OR = 0.08) and band like shape of abnormal signal(OR = 0.07) were associated with benign VCFs.Conclusion. Several specific MRI features using signal intensity characteristics, morphological characteristics, quantitative techniques and findings at other levels can be useful for distinguishing benign from malignant VCF and serve as inputs for a prediction model. Observer performance reliability has not been adequately assessed. |
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Authors:
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Shrey K Thawait; Matthew A Marcus; William B Morrison; Roman A Klufas; John Eng; Ja Carrino |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-12-28 |
Journal Detail:
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Title: Spine Volume: - ISSN: 1528-1159 ISO Abbreviation: - Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2012-1-2 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7610646 Medline TA: Spine (Phila Pa 1976) Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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1Bridgeport hospital, Yale New Haven Health System, 267 Grant Street, Bridgeport, CT 06610 2Pitts Radiology, 1519 Marion Street, Columbia, SC 29201 3Thomas Jefferson University Hospital, 132 S 10th St Philadelphia, PA 19107 4Brigham and Women's Hospital, 15 Francis Street, Boston, MA 02115 5Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD 21287. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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