Comparative diagnostic value and therapeutic relevance of magnetic resonance imaging and bone marrow scintigraphy in patients with metastatic solid tumors of the axial skeleton.
OBJECTIVE
To evaluate the comparative impact of magnetic resonance imaging (MRI) and bone marrow scintigraphy (BMS) in bone marrow metastases of solid tumors.


METHODS
In 20 patients with solid tumors MRI of the axial skeleton and whole-body BMS were retrospectively reviewed. Detectability of metastases, extent of disease and therapeutic implications were assessed.


RESULTS
In 15/20 (75%) patients MRI and BMS concordantly revealed bone marrow metastases of the axial skeleton. In nine of these 15 patients (60%) MRI showed more metastases. Local radiotherapy or surgery was performed in seven of these cases (78%). BMS detected additional metastases of the appendicular skeleton in 8/15 (53%) patients. In 4/20 cases (20%) the imaging findings were discordant. In three patients with degenerative changes (n=2) or lipoma (n=1) BMS was false positive. In another patient BMS failed to detect metastases proven by MRI and clinical follow-up resulting in subsequent radiation therapy. One patient had normal bone marrow.


CONCLUSIONS
MRI appears to be more sensitive and specific in the detection of bone marrow metastases in the axial skeleton and is of clinical importance for subsequent local therapy.
Department of Diagnostic Radiology, University Hospital Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany. gha@mrsl.ukl.uni-freiburg.de
Nadir
N
Ghanem
Carsten
C
Altehoefer
Stefan
S
Högerle
Oliver
O
Schäfer
Jan
J
Winterer
Ernst
E
Moser
Mathias
M
Langer
D019046:Bone Marrow Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary* / Q000628:therapy; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary* / Q000628:therapy; D001943:Breast Neoplasms / Q000473:pathology; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D011859:Radiography; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D001749:Urinary Bladder Neoplasms / Q000473:pathology