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Magnetic Resonance Imaging Of Metastatic Bone Disease

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Bone Metastases

Part of the book series: Cancer Metastasis – Biology and Treatment ((CMBT,volume 12))

Abstract

Early diagnosis of bone metastases is crucial in order to determine the prognosis and optimize therapy. Traditional methods, such as plain radiography or bone scintigraphy, lack either sensitivity or specificity. Computed tomography (CT) is quite sensitive, however, its ability to detect early deposits is limited. FDG {PET – CT} scan detects metastatic bone disease before occurrence of osteoblastic activity. Magnetic resonance imaging (MRI) has been shown to be the most sensitive imaging technique, with a sensitivity of up to 100% reported and its specificity was reported to reach 97%.

MRI of bone metastases depends on the degree of bone resorption or deposition. The lesion pattern may be lytic, sclerotic or mixed. Adequate characterization of lesions depends on fat and water distribution in bone marrow, normal bone trabeculae, tissue vascularization, cell density and bone oedema. T1 – weighted spin – echo (SE), T2 – weighted turbo SE and STIR are the sequences most frequently used. Gadolinium enhancement demonstrates areas of greatest tumor activity. Diffusion-weighted imaging helps in the discrimination between benign and malignant vertebral body compression fractures. Whole-body MRI is a feasible alternative to bone scintigraphy in evaluating the entire skeleton.

MRI is the modality of choice for the evaluation of bone metastases. It’s a non invasive technique, presenting great tissue contrast, without the use of ionizing radiation. MRI depicts metastases in an early stage and provides additional information about tumor extent. It helps in tumor screening and staging, as well as in the control of the disease progression and the post treatment evaluation.

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Author information

Authors and Affiliations

  1. Department of Clinical Radiology, Magnetic Resonance Unit, Uni-versity of Patras Medical School, 26500, Patras, Greece

    Ekaterini Solomou, Alexandra Kazantzi & Odysseas Romanos

  2. Department of Radiation Oncology, University of Patras Medical School, Patras, Greece

    Dimitrios Kardamakis

Authors
  1. Ekaterini Solomou
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  2. Alexandra Kazantzi
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  3. Odysseas Romanos
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  4. Dimitrios Kardamakis
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Correspondence to Ekaterini Solomou .

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Editors and Affiliations

  1. Dept. of Radiation Oncology, University of Patras Medical School, 265 04, Patras, Greece

    Dimitrios Kardamakis MD, PhD, DMRT  & Vassilios Vassiliou MD, PhD  & 

  2. Dept. of Radiation Oncology, University of Toronto Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada

    Edward Chow MBBS, PhD, FRCPC

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Solomou, E., Kazantzi, A., Romanos, O., Kardamakis, D. (2009). Magnetic Resonance Imaging Of Metastatic Bone Disease. In: Kardamakis, D., Vassiliou, V., Chow, E. (eds) Bone Metastases. Cancer Metastasis – Biology and Treatment, vol 12. Springer, Dordrecht. https://doi.org/10.1007/978-1-4020-9819-2_8

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