title: MRI and (18)FDG-PET in the assessment of bone marrow infiltration of the spine in cancer patients.
abstract: The aim of this study was to evaluate the diagnostic value of MRI and (18)FDG-PET in bone marrow infiltration of the spine due to metastases of solid tumours and lymphoma in cancer patients. In 35 cancer patients (solid tumours n = 26, lymphoma n = 9) MRI of the spine and (18)FDG-PET were reviewed and the detectability of metastases, infiltration of the spine, extent of disease, and therapeutic implications were compared. In 8/35 cases (23%) imaging technique showed concordantly no bone marrow infiltration. In 19/35 patients (54%), both MRI and (18)FDG-PET revealed bone marrow infiltration of the axial skeleton. In 12/19 patients (63%), MRI showed more extensive disease which lead to subsequent therapy. The imaging findings of MRI and (18)FDG-PET were discordant in 8/35 cases (23%). (18)FDG-PET was false positive in two patients. In six patients, (18)FDG-PET failed to detect bone metastases and bone marrow infiltration of the spine, which was detected by MRI and proven by clinical follow-up with subsequent therapy in two cases. MRI is more sensitive and specific than (18)FDG-PET detecting bone marrow metastases and infiltration of the spine and has a great impact in staging cancer patients.
authors.affiliation: Department of Diagnostic Radiology, University Hospital Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany. nadir.ghanem@uniklinik-freiburg.de
authors.forename: Nadir Alexander
authors.initials: NA
authors.lastname: Ghanem
authors.forename: Gregor
authors.initials: G
authors.lastname: Pache
authors.forename: Christian
authors.initials: C
authors.lastname: Lohrmann
authors.forename: Ingo
authors.initials: I
authors.lastname: Brink
authors.forename: Thorsten
authors.initials: T
authors.lastname: Bley
authors.forename: Elmar
authors.initials: E
authors.lastname: Kotter
authors.forename: Thomas
authors.initials: T
authors.lastname: Kelly
authors.forename: Mathias
authors.initials: M
authors.lastname: Langer
mesh_terms: D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D017254:Leukemic Infiltration / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D013131:Spine / Q000473:pathology*
chemical_list: D019788:Fluorodeoxyglucose F18