Application of IDEAL-IQ and IVIM-DWI in Diagnosis and Source Evaluation of Spinal Metastases
WANG Shuaina
BA Yiwen
YAN Ruifang
REN Jipeng
YIN Huijia
HAN Dongming
Abstract：Objective To explore the value of iterative decomposition of water and fat with echo asymmetry and the least squares estimation quantification sequence(IDEAL-IQ)and intravoxel incoherent motion(IVIM)in the diagnosis and source evaluation of spinal metastases.Methods A total of 40 spinal metastases(40 vertebral lesions,of which,25 were lung cancer metastases and 15 were non-lung cancer metastases)and 12 with normal spines(36 normal vertebral bodies)underwent IDEAL-IQ and IVIM scans.Differences in fat fraction(FF),R2*,stand average diffusion coefficient(ADCstand),diffusion coefficient(D),pseudo diffusion coefficient(D*),perfusion fraction(f),distributed diffusion coefficient(DDC)and diffusion heterogeneity index(α)values were measured and compared between the metastatic tumour and normal groups and between the lung cancer metastatic and non-lung cancer metastatic groups,respectively.Logistic regression analysis was used to search for independent predictors,and the receiver operating characteristic(ROC)curve and DeLong test were respectively used to evaluate the diagnostic efficacy and the differences among different areas under the curve(AUC).Results In the diagnosis of spinal metastases,FF,R2*,ADCstand,D,D*,f,DDC,and α values were lower in the metastasis group than in the normal group(P＜0.05).FF and D were independent predictors,with an AUC of 0.962 for the combination of the two,a sensitivity of 87.50％and a specificity of 97.22％.DeLong analysis showed that AUC(FF+D)and AUC(FF),AUC(R2*),AUC(ADCstand),AUC(D),AUC(D*),AUC(f),AUC(DDC)and AUC(α)were all statistically significant(P＜0.05).In terms of metastatic tumour source assessment,both FF and DDC values were higher in the lung cancer metastasis group than in the non-lung cancer metastasis group(P＜0.05),with FF being an independent predictor with an AUC of 0.761,sensitivity of 72.00％and specificity of 73.33％.DeLong analysis showed that the difference in AUC between FF and DDC was not statistically significant(P＞0.05).Conclusion Both IDEAL-IQ and IVIM have a role to play in the diagnosis and source assessment of spinal metastases,and some of the quantitative parameters are expected to be reliable imaging markers.
Keywords：spinal metastaseswater-fat separation technologyintravoxel incoherent motiondiagnosissource
Publication Date：2025-11-13
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：7( 3841-3847 )