advances in Magnetic resonance imaging sequences which include the in-phase and out of phase sequences are helpful in the assessment of worrying vertebral marrow lesion especially if the patients presented with primary malignancy outside the spines.
Objectives: The study aimed to evaluate the role of spinal MR (magnetic resonance) imaging in the evaluation of bone marrow lesion in patients with primary malignancy using in-phase and out of phase sequences in addition to conventional MR sequences.
Methods: This is a cross-sectional study included 80 patients referred to MR unit from the oncology department in oncology teaching hospital – medical City, Baghdad, Iraq during the period from the beginning of September 2018 to October 2019, 22 of them having no cancer and referred to MRI due to lower back pain while the remaining 58 patients had primary non-osseous cancer and referred complaining from back pain and exclude bony metastasis.
Results: the study sample consisted of 55 females and 25 males, the breast cancer is the main primary in females and represent 30/58 patients while the prostate cancer is main cancer in males and represent 7/58 patients, Most of the suspicious lesions appearing low on T1W, high on T2W and Fatsat sequences this represents seen in (27.5%) of those only (12%) patients are really metastasis, while when adding the high out of phase/in phase ratio, the percentage decrease from 27.5% to 8.5%, the sensitivity, specificity, positive predictive value (PPV) and negative predictive valve (NPV) and overall accuracy of out of phase/ in phase ratio in detecting metastasis within the vertebral marrow are 66.6%, 90.7%, 61.4%, 92.4%, and 86% respectively.
Conclusion: Utilizing in phase and out of phase sequences and calculating the OIR greatly assist in diagnosing suspicious marrow lesions, hence this technique is greatly reducing the need for Intravenous contrast administration.