Whole-body MRI in comparison to skeletal scintigraphy in detection of skeletal metastases in patients with solid tumors.
OBJECTIVE
To evaluate the diagnostic value of whole-body magnetic resonance imaging (MRI) and skeletal scintigraphy in the detection of skeletal metastases in patients with solid tumors.


METHODS
One hundred and twenty-nine tumor patients were examined with whole-body MRI using coronal TIRM sequences for the different anatomical regions. Skeletal scintigraphy was performed with 99mTc-DPD.


RESULTS
In 105/129 (81%) patients, the whole-body MRI and skeletal scintigraphy findings were concordant. In 56/129 (43%) patients, both imaging modalities excluded skeletal metastases. In 49/129 (38%) patients, whole-body MRI and skeletal scintigraphy revealed metastases, however whole-body MRI demonstrated more extensive disease in 22/49 (45%) cases. In 6/49 (12%) cases, skeletal scintigraphy was superior to whole-body MRI in detecting more skeletal metastases. In 24/129 (19%) cases, the imaging findings were discordant. In 15 cases, skeletal scintigraphy was negative, whereas whole-body MRI revealed skeletal metastases. In 9 cases, skeletal scintigraphy was positive, whereas whole-body MRI failed to detect these metastases. In 77/129 (60%) patients, whole-body MRI revealed additional tumor-related findings.


CONCLUSIONS
Whole-body MRI, as a new staging method, is superior to skeletal scintigraphy with respect to the detection of skeletal metastases and the extent of metastastic disease. Furthermore, whole-body MRI yields additional tumor-related findings. Therefore, whole-body MRI should be performed as an alternative to skeletal scintigraphy for the assessment of skeletal metastases.
Ghanem
N
N
Departments of Diagnostic Radiology, University Hospital Freiburg, 79106 Freiburg, Germany. gha@mrs1.ukl.uni-freiburg.de
Altehoefer
C
C
Kelly
T
T
Lohrmann
C
C
Winterer
J
J
Schäfer
O
O
Bley
T A
TA
Moser
E
E
Langer
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging / Q000379:methods*