Detection of osseous metastases of the spine: comparison of high resolution multi-detector-CT with MRI.
OBJECTIVE
The aim of the study was to evaluate the diagnostic accuracy of multi-slice-computed tomography (MDCT) for the detection of vertebral metastases in comparison to magnetic resonance imaging (MRI).


METHODS
In a retrospective analysis, 639 vertebral bodies of 41 patients with various histologically confirmed primary malignancies were analysed. The MDCT-images were acquired on a 16/64-row-MDCT scanner (Siemens Somatom Sensation 16/64). MRI was performed on 1.5 T scanners (SIEMENS Symphony/Sonata). The MDCT- and MRI-images were evaluated separately by two experienced radiologists in a consensus reading. The combination of MDCT and MRI in an expert reading including follow-up examinations and/or histology as well as clinical data served as the gold standard.


RESULTS
201/639 vertebral bodies were defined as metastatically affected by the gold standard. In MDCT 133/201 lesions, in MRI 198/201 lesions were detected. 68 vertebral bodies were false negative in MDCT, whereas 3 false negatives were found in MRI. 3 false positive results were obtained in MDCT, 5 in MRI. Sensitivity was significantly lower for MDCT (66.2%) than for MRI (98.5%) (p<0.0001). Specificity was not significantly different for both methods (MDCT: 99.3%; MRI: 98.9%). The diagnostic accuracy resulted in 88.8% for MDCT and 98.7% for MRI.


CONCLUSIONS
Although 16/64-row-MDCT provides excellent image quality and a high spatial resolution in the assessment of bony structures, metastatic lesions without significant bone destruction may be missed. The diagnostic accuracy of MRI proved to be significantly superior to 16/64-row-MDCT for the detection of osseous metastases.
Buhmann Kirchhoff
Sonja
S
Department of Radiology, University Hospital Munich-Grosshadern, Marchioninistrasse 15, 81377 Munich, Germany. Sonja.Buhmann@med.uni-muenchen.de
Becker
Christoph
C
Duerr
Hans Roland
HR
Reiser
Maximilian
M
Baur-Melnyk
Andrea
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013125:Spinal Neoplasms / Q000175:diagnosis* / Q000556:secondary*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult