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Background <p>To evaluate the diagnostic value of intravoxel incoherent motion (IVIM) and dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) parameters in distinguishing between benign and malignant bone tumors while analyzing their correlations with Ki-67 expression.</p> Methods <p>This study was a retrospective analysis of 50 patients with pathologically confirmed bone tumors. By using t tests or Mann‒Whitney U tests, the diagnostic performance of quantitative parameters from IVIM (ADC, D, D*, f) and DCE-MRI (K<sup>trans</sup>, K<sub>ep</sub>, V<sub>e</sub>, iAUC) in distinguishing benign from malignant bone tumors was evaluated and compared at a significance level of <i>P</i> = 0.05. Patients were divided into high and low Ki-67 expression groups according to a 20% cutoff. Spearman’s rank correlation analysis was used to evaluate the relationships between imaging parameters and Ki-67 expression levels.</p> Results <p>Compared with the benign group, the malignant group presented significantly lower ADC and D values (<i>P</i> &lt; 0.001 for all), along with significantly higher D*, f, K<sup>trans</sup>, K<sub>ep</sub>, and iAUC values (<i>P</i> ≤ 0.001 for all). No significant difference was observed in the V<sub>e</sub> value (<i>P</i> = 0.236). Among all the quantitative parameters, the ADC and K<sup>trans</sup> demonstrated the highest diagnostic performance in distinguishing benign lesions from malignant lesions (AUC = 0.998, 0.998). K<sup>trans</sup> was strongly positively correlated with Ki-67 (<i>r</i> = 0.705), whereas K<sub>ep</sub>, iAUC, D*, and f were moderately positively correlated (<i>r</i> = 0.567, 0.589, 0.463, 0.499). Conversely, ADC and D displayed moderate negative correlations with Ki-67 (<i>r</i> = -0.564, -0.527), whereas V<sub>e</sub> had only a weak positive correlation (<i>r</i> = 0.312).</p> Conclusions <p>IVIM and DCE-MRI parameters have important value in distinguishing benign and malignant bone tumors, except for V<sub>e</sub> in DCE-MRI parameters. It is worth noting that K<sup>trans</sup> is strongly correlated with postoperative Ki-67 expression grading and is suitable as an exploratory or auxiliary biomarker, which can be used as a supplement to biopsy and histopathological examination.</p>

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Diagnostic value of IVIM and DCE-MRI parameters for differentiating benign from malignant bone tumors and their correlations with Ki-67 expression

  • 期刊论文

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  • 发表日期：

    2026年1月10日

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  • Mingui Lin,
  • Xianyuan Chen,
  • Ying Peng,
  • Chaohong Yang,
  • Rongjing Wang

摘要

Background

To evaluate the diagnostic value of intravoxel incoherent motion (IVIM) and dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) parameters in distinguishing between benign and malignant bone tumors while analyzing their correlations with Ki-67 expression.

Methods

This study was a retrospective analysis of 50 patients with pathologically confirmed bone tumors. By using t tests or Mann‒Whitney U tests, the diagnostic performance of quantitative parameters from IVIM (ADC, D, D*, f) and DCE-MRI (Ktrans, Kep, Ve, iAUC) in distinguishing benign from malignant bone tumors was evaluated and compared at a significance level of P = 0.05. Patients were divided into high and low Ki-67 expression groups according to a 20% cutoff. Spearman’s rank correlation analysis was used to evaluate the relationships between imaging parameters and Ki-67 expression levels.

Results

Compared with the benign group, the malignant group presented significantly lower ADC and D values (P < 0.001 for all), along with significantly higher D*, f, Ktrans, Kep, and iAUC values (P ≤ 0.001 for all). No significant difference was observed in the Ve value (P = 0.236). Among all the quantitative parameters, the ADC and Ktrans demonstrated the highest diagnostic performance in distinguishing benign lesions from malignant lesions (AUC = 0.998, 0.998). Ktrans was strongly positively correlated with Ki-67 (r = 0.705), whereas Kep, iAUC, D*, and f were moderately positively correlated (r = 0.567, 0.589, 0.463, 0.499). Conversely, ADC and D displayed moderate negative correlations with Ki-67 (r = -0.564, -0.527), whereas Ve had only a weak positive correlation (r = 0.312).

Conclusions

IVIM and DCE-MRI parameters have important value in distinguishing benign and malignant bone tumors, except for Ve in DCE-MRI parameters. It is worth noting that Ktrans is strongly correlated with postoperative Ki-67 expression grading and is suitable as an exploratory or auxiliary biomarker, which can be used as a supplement to biopsy and histopathological examination.