Feasibility of echo asymmetry and least squares estimation (IDEAL-IQ) in differentiation of atypical spinal hemangiomas from metastases

Motivation: It is common for patients with primary tumors to find abnormal signals in the spine, which may be initially reported as “metastases cannot be rule out”. For these cases, differential diagnosis has a significant impact on patient staging and management, which may result in misdiagnosis or additional imaging, ultimately biopsy, and unnecessary costs. Goal(s): To investigate chemical shift-encoded sequence (IDEAL-IQ) for differential diagnosis of spinal tumors. Approach: Single-center prospective study. Results: This work highlights the benefits of adding proton density fat fraction (PDFF) maps yield from IDEAL-IQ to improve diagnostic accuracy of spinal metastases and hemangiomas without contrast agents. Impact: IDEAL-IQ provides reliable quantification of spinal tumor bone marrow infiltration pattern in clinical settings, which is comparable to the quantitative parameters of DCE-MRI. It may be a valuable tool for providing information for early differential diagnosis in a non-invasive way.