Contrast-Enhanced 3-T Perfusion MRI With Quantitative Analysis for the Characterization of Musculoskeletal Tumors: Is It Worth the Trouble?

OBJECTIVE. The purpose of this study was to evaluate the diagnostic performance of quantitative perfusion parameters in 3-T MRI for benign-malignant differentiation in musculoskeletal tumors. SUBJECTS AND METHODS. Ninety-five patients with histologically proven musculoskeletal tumors were prospectively included in this study. All patients underwent 3-T contrast-enhanced perfusion MRI with T1 mapping. The extended Tofts pharmacokinetic model was used to obtain four semiquantitative and four quantitative perfusion parameters for each tumor. Two radiologists evaluated all images and manually placed the ROIs in consensus. RESULTS. The 95 patients had 57 (59%) benign and 38 (41%) malignant tumors. Thirty-seven (39%) were bone and 58 (61%) were soft-tissue tumors. No significant differences were found in the perfusion parameters of benign and malignant tumors (p = 0.105–0.609). The best performance for benign-malignant differentiation was found for fractional volume of the extravascular extracellular space, whi...