title: Role of whole-body diffusion-weighted MRI in detecting bone metastasis.
abstract: OBJECTIVE
  The aim of this study was to compare the results of whole-body diffusion-weighted magnetic resonance (DW-MR) imaging with staging based on computed tomography (CT) and nuclear scintigraphy using Tc99m results as the standard of reference.
  
  
  METHODS
  Seventeen patients with known malignant tumours were included in the study. The thorax and the abdomen were imaged using breath-hold diffusion-weighted imaging and T1-weighted imaging sequences in the coronal plane. Location and size of osseous metastases were documented by two experienced radiologists. Whole-body DW-MR imaging findings were compared with results obtained at skeletal scintigraphy and CT bone survey.
  
  
  RESULTS
  The mean examination time for whole-body DW-MR imaging was 25.5 min. All bone metastases regardless of the size were identified with whole-body DW-MR imaging; MR imaging depicted more bone metastases than CT. Skeletal scintigraphy depicted osseous metastases in 13 patients (with greater sensitivity to the lower limb), whereas whole-body DW-MR imaging revealed osseous metastases in 13 patients (with greater sensitivity to the spine). DW-MR did not show good results for detection of rib cage metastases. The additional osseous metastases seen with MR imaging were confirmed at follow-up examinations and some had a change in therapy. MR identified 22% more metastatic lesions when compared to bone scintigraphy and 119% when compared to CT. Bone scintigraphy identified 80% more metastatic lesions when compared to CT. On a per-patient basis, whole-body DW-MR imaging revealed sensitivity and specificity values of 100%.
  
  
  CONCLUSIONS
  Whole-body DW-MR imaging was more sensitive in the detection of osseous metastases than were skeletal scintigraphy and CT bone survey.
authors.affiliation: Department of Radiology, Campus Bio-Medico University of Rome, Rome, Italy, r.delvescovo@unicampus.it.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Del Vescovo
authors.forename: Giulia
authors.initials: G
authors.lastname: Frauenfelder
authors.forename: Francesco
authors.initials: F
authors.lastname: Giurazza
authors.forename: Claudia Lucia
authors.initials: CL
authors.lastname: Piccolo
authors.forename: Roberto Luigi
authors.initials: RL
authors.lastname: Cazzato
authors.forename: Rosario Francesco
authors.initials: RF
authors.lastname: Grasso
authors.forename: Emiliano
authors.initials: E
authors.lastname: Schena
authors.forename: Bruno Beomonte
authors.initials: BB
authors.lastname: Zobel
mesh_terms: D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000556:secondary; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D051598:Whole Body Imaging / Q000379:methods
chemical_list: D019275:Radiopharmaceuticals