ACR appropriateness criteria on metastatic bone disease.
Appropriate imaging modalities for screening, staging, and surveillance of patients with suspected and documented metastatic disease to bone include (99m)Tc bone scanning, MRI, CT, radiography, and 2-[(18)F]fluoro-2-deoxyglucose-PET. Clinical scenarios reviewed include asymptomatic stage 1 breast carcinoma, symptomatic stage 2 breast carcinoma, abnormal bone scan results with breast carcinoma, pathologic fracture with known metastatic breast carcinoma, asymptomatic well-differentiated and poorly differentiated prostate carcinoma, vertebral fracture with history of malignancy, non-small-cell lung carcinoma staging, symptomatic multiple myeloma, osteosarcoma staging and surveillance, and suspected bone metastasis in a pregnant patient. No single imaging modality is consistently best for the assessment of metastatic bone disease across all tumor types and clinical situations. In some cases, no imaging is indicated. The recommendations contained herein are the result of evidence-based consensus by the ACR Appropriateness Criteria((R)) Expert Panel on Musculoskeletal Radiology.
Roberts
Catherine C
CC
Mayo Clinic, Phoenix, Arizona 85054, USA.
Daffner
Richard H
RH
Weissman
Barbara N
BN
Bancroft
Laura
L
Bennett
D Lee
DL
Blebea
Judy S
JS
Bruno
Michael A
MA
Fries
Ian Blair
IB
Germano
Isabelle M
IM
Holly
Langston
L
Jacobson
Jon A
JA
Luchs
Jonathan S
JS
Morrison
William B
WB
Olson
Jeffrey J
JJ
Payne
William K
WK
Resnik
Charles S
CS
Schweitzer
Mark E
ME
Seeger
Leanne L
LL
Taljanovic
Mihra
M
Wise
James N
JN
Lutz
Stephen T
ST
D001859:Bone Neoplasms / Q000175:diagnosis* / Q000556:secondary*; D001943:Breast Neoplasms / Q000473:pathology; D003952:Diagnostic Imaging / Q000592:standards*; D019317:Evidence-Based Medicine / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis; D011471:Prostatic Neoplasms / Q000473:pathology; D014481:United States