{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T00:21:03Z","timestamp":1787962863211,"version":"build-2784847793"},"reference-count":27,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2011,2]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Differentiation between malignant and benign vertebral compression fractures (VCFs) is important but sometimes difficult, especially in elderly cancer patients. The authors investigated the findings of MR imaging and FDG-PET\/CT for the differentiation of VCFs.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Between 2007 and 2008, the authors evaluated and treated 102 VCFs in 96 patients. The final diagnosis, based on biopsy results or clinical follow-up, was benign fracture in 67 lesions in 65 patients and malignant fracture in 35 lesions in 31 patients. Magnetic resonance images were obtained in all patients, and FDG-PET\/CT was performed in 17 patients in the benign fracture group and 20 in the malignant fracture group. The prevalence of 3 significant MR imaging findings (posterior cortical bulging, epidural mass formation, and pedicle enhancement) and the presence of radiotracer uptake on FDG-PET\/CT were evaluated in the 2 groups. The maximum standardized uptake value (SUV<jats:sub>max<\/jats:sub>) on FDG-PET\/CT was compared between the 2 groups, and diagnostic threshold value was sought to confirm malignancy. The diagnostic accuracy of MR imaging and FDG-PET\/CT was compared in the differentiation of malignant from benign VCFs.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Posterior cortical bulging was seen in 26 (74%) of 35 malignant lesions and 30 (45%) of 67 benign ones, epidural mass formation in 27 (77%) of the malignant lesions and 25% of the benign ones, and pedicle enhancement in 30 (91%) of the 33 malignant lesions and 18 (39%) of the 46 benign ones evaluated with Gd-enhanced MR imaging. These differences were statistically significant for each feature. Sensitivity and specificity for predicting malignancy were, respectively, 74% and 55% for posterior cortical bulging, 77% and 74% for epidural mass formation, and 90% and 61% for pedicle enhancement. Simultaneous occurrence of 3 significant features was found in 21 (64%) of the 33 malignant and 8 (17%) of the 46 benign lesions for which complete MR imaging data were available and showed sensitivity of 64% and specificity of 83%. The presence of radiotracer uptake on FDG-PET\/CT was seen in all 20 (100%) of the 20 malignant lesions and 12 (71%) 17 of the benign lesions evaluated by FDG-PET\/CT and showed a sensitivity of 100% and specificity of 29%. There was a significant difference in mean (\u00b1 SD) SUV<jats:sub>max<\/jats:sub> for the malignant (6.29 \u00b1 3.50) and benign (2.38 \u00b1 1.90) lesions (p &lt; 0.001). The most reliable threshold for SUV<jats:sub>max<\/jats:sub> was found to be 4.25, which yielded a sensitivity of 85% and a specificity of 71%.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>When MR imaging findings are equivocal, FDG-PET\/CT can be considered as an adjunctive diagnostic method for differentiating malignant from benign VCFs. In comparison with MR imaging, FDG-PET\/CT showed slightly higher sensitivity and lower specificity.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2010.10.spine10175","type":"journal-article","created":{"date-parts":[[2011,1,7]],"date-time":"2011-01-07T15:02:24Z","timestamp":1294412544000},"page":"177-183","source":"Crossref","is-referenced-by-count":39,"title":["Comparison of MR imaging and FDG-PET\/CT in the differential diagnosis of benign and malignant vertebral compression fractures"],"prefix":"10.3171","volume":"14","author":[{"given":"Won-Ik","family":"Cho","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ung-Kyu","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-spine10175","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1148\/radiology.207.2.9577479","article-title":"Diffusion-weighted MR imaging of 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