Malignant versus benign vertebral collapse: are new imaging techniques useful?

Benign and malignant vertebral collapse is common in the middle-aged and elderly population. Differential diagnosis sometimes remains difficult using radiographs, computed tomography (CT) and magnetic resonance imaging (MRI) if strong edema is present. Established morphological criteria and new methods such as positron emission tomography (PET)-CT and diffusion and perfusion MRI are helpful for the correct diagnosis. Increased fluorodeoxyglucose (FDG) uptake accounts for the neoplastic cause of a fracture. Hyperintensity on diffusion-weighted images and a high plasma flow also are associated with the malignant cause of a fracture. However, the combination of all criteria should be taken into account for differential diagnosis.