Differential diagnosis of focal changes in the spine using standard and radiomic analysis

BACKGROUND: If focal changes in the bones are detected, the radiologist must exclude or confirm the presence of a metastatic lesion. Although the semiotics of metastatic and non-oncological changes according to magnetic resonance imaging (MRI) data is well known, in practice, there may be various combinations of their characteristics that are influenced by other chronic diseases and parallel processes, which significantly complicate interpretation. The use of computer image analysis methods has great prospects and can improve the diagnostic accuracy of standard imaging methods.

OBJECTIVE: To improve the accuracy of diagnosing radiographic findings of focal changes in the spine using additional image evaluation by computer analysis algorithms.

MATERIALS AND METHODS: Thirty patients were examined, and 15 of them had metastatic bone lesions from breast cancer, and 15 had focal changes in the spine of a non-oncological nature. Computer analysis of focal changes in the vertebral bodies was conducted according to T₁WI, T₂WI, and STIR MRI sequences. For the computer analysis, the operator of the complexity of the image Arzela and histogram distribution of brightness were used.

RESULTS: The main differential indicators for hemangioma, conditionally normal areas of the bone marrow, and metastatic foci have been established. The Arzela data image complexity operator was approximately 0.07 for hemangioma, approximately 0.05 for metastases (mts), and approximately 0.04 for vertebrae. The brightness histogram operator was approximately 1.12 for haemangioma and approximately 0.94 for mts. Regarding the difference between indicators, the difference is 20%–25%, between hemangioma and bone marrow and 35% between mts and bone marrow, which make it possible to effectively use these indicators together with other markers.

CONCLUSION: The criteria for differential diagnosis obtained using radiomic analysis showed significant differences between focal changes in the vertebrae of various etiologies. From a mathematical point of view, they are advisory, and the doctor with experience remains at the center of the decision-making system.