Diagnostic significance of multisequence MRI radiomics models in distinguishing benign and malignant spinal fractures

Purpose: To investigate the diagnostic value of multi-sequence magnetic resonance imaging (MRI) in benign and malignant spinal fractures. Materials and methods: MRI data of patients with pathologically confirmed malignant vertebral fractures were retrospectively collected and compared with those with benign vertebral fractures. The image omics features of T1-weighted imaging (T1WI) and T2-weighted imaging (T2WI) were extracted respectively, and were randomly divided into training and test sets at 8:2. The training set adopted recursive feature elimination method and minimum absolute contraction and selection operator (LASSO) regression to screen the variables. Three image omics models, T1WI, T2WI and the combination of two sequences, were constructed by logistic regression, and the diagnostic efficiency of each model was verified by the test set. The receiver operating curve evaluated the diagnostic efficiency of the model. Results: A total of 111 vertebrae with fracture were included in 97 patients, 55 with benign fracture and 56 with malignant fracture. In the training set, the AUC, sensitivity and specificity of the T1WI model were 0.892, 88.9% and 81.4%, respectively. In T2WI model, the results were 0.924, 82.2% and 95.3%, respectively. The combined models of the two sequences were 0.934, 90.0% and 87.5%, respectively. In the test set, the AUC, sensitivity and specificity of T1WI model were 0.877, 80.0% and 92.3%, respectively. In T2WI model, the results were 0.923, 90.0% and 92.3%, respectively. The combined models were 0.933, 100.0% and 87.5%, respectively. The diagnostic efficiency of the two-sequence combined image omics model was better than that of the radiologist. Conclusion: The combined model, incorporating T1WI and T2WI, outperformed single-sequence models in terms of diagnostic accuracy. The integration of multisequence radiomic features provided enhanced texture information, contributing to superior accuracy and efficiency in diagnosing malignant spinal fractures.