Diagnostic value of magnetic resonance imaging and scintigraphy in patients with metastatic breast cancer of the axial skeleton: a comparative study.
OBJECTIVE
The goal of this study was to compare the sensitivity of MRI and scintigraphy for detecting metastatic bone disease involving the axial skeleton.


METHODS
A total of 59 patients (58 women and 1 man, age range 28-83 years, mean age 53.0 years) with histopathologically proven breast cancer during a 15-month period (between April 2003 and January 2004) were included in the study. All the patients underwent scintigraphy and MRI examinations for staging, follow-up, or evaluation of bone pain.


RESULTS
MR imaging revealed 59 metastases in 59 patients (sensitivity, 95%; specificity, 100%; positive predictive value, 100%). Four lesions detected by MRI were classified as of uncertain origin (grade 2) and 36 lesions were regarded as definitely benign (grade 1). Scintigraphy revealed 44 metastases in 59 patients (sensitivity, 70%; specificity, 94%; positive predictive value, 95%). A total of 29 lesions were considered as of uncertain origin (grade 2), and 26 lesions were regarded as definitely benign (grade 1). About five lesions were graded as grade 2 in scintigraphy, while MRI graded them as degeneration or benign compression (Grade 1). For 11 lesions the same grade was regarded in both MRI and scintigraphy. Two lesions graded as grade 3, and eleven lesions graded as grade 2 in scintigraphy demonstrated no pathological signal intensity in MRI. In total, 18 lesions with no activity in scintigraphy were graded as grade 3 lesions in MRI.


CONCLUSIONS
MRI is more sensitive than scintigraphy in the detection of bone metastases. MRI appears to be able to screen patients more effectively than scintigraphy if the spine and pelvis are included because metastases merely outside the axial skeleton are rare.
Department of Radiology, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey.
Mehmet Halit
MH
Yilmaz
Mustafa
M
Ozguroglu
Devrim
D
Mert
Hande
H
Turna
Gökhan
G
Demir
Ibrahim
I
Adaletli
Sila
S
Ulus
Metin
M
Halac
Kaya
K
Kanberoğlu
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary*; D001943:Breast Neoplasms / Q000473:pathology*; D004164:Diphosphonates; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D015609:Organotechnetium Compounds; D011237:Predictive Value of Tests; D011859:Radiography; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D051598:Whole Body Imaging
D004164:Diphosphonates; D015609:Organotechnetium Compounds; C114890:technetium 99m methylene bisphosphonate