title: Monitoring the response of bone metastases to treatment with Magnetic Resonance Imaging and nuclear medicine techniques: a review and position statement by the European Organisation for Research and Treatment of Cancer imaging group.
abstract: Assessment of the response to treatment of metastases is crucial in daily oncological practice and clinical trials. For soft tissue metastases, this is done using computed tomography (CT), Magnetic Resonance Imaging (MRI) or Positron Emission Tomography (PET) using validated response evaluation criteria. Bone metastases, which frequently represent the only site of metastases, are an exception in response assessment systems, because of the nature of the fixed bony defects, their complexity, which ranges from sclerotic to osteolytic and because of the lack of sensitivity, specificity and spatial resolution of the previously available bone imaging methods, mainly bone scintigraphy. Techniques such as MRI and PET are able to detect the early infiltration of the bone marrow by cancer, and to quantify this infiltration using morphologic images, quantitative parameters and functional approaches. This paper highlights the most recent developments of MRI and PET, showing how they enable early detection of bone lesions and monitoring of their response. It reviews current knowledge, puts the different techniques into perspective, in terms of indications, strengths, weaknesses and complementarity, and finally proposes recommendations for the choice of the most adequate imaging technique.
authors.affiliation: MRI Unit, Dept of Radiology, Centre du Cancer and Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Brussels, Belgium. Electronic address: frederic.lecouvet@uclouvain.be.
authors.forename: F E
authors.initials: FE
authors.lastname: Lecouvet
authors.affiliation: Dept of Nuclear Medicine, Hôpital Tenon, AP-HP & Université Pierre et Marie Curie, Paris, France.
authors.forename: J N
authors.initials: JN
authors.lastname: Talbot
authors.affiliation: Dept of Radiology, Royal Marsden Hospital, Downs Road, Sutton, Surrey SM2 5PT, United Kingdom.
authors.forename: C
authors.initials: C
authors.lastname: Messiou
authors.affiliation: Dept of Nuclear Medicine, Cancer Center Eugène Marquis and University of Rennes 1, Rennes, France.
authors.forename: P
authors.initials: P
authors.lastname: Bourguet
authors.affiliation: EORTC, TR, Radiotherapy and Imaging Department, EORTC Headquarters, Brussels, Belgium.
authors.forename: Y
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Dept of Radiology, Royal Marsden Hospital, Downs Road, Sutton, Surrey SM2 5PT, United Kingdom; MRI Unit, Institute of Cancer Research and Royal Marsden Hospital, Downs Road, Sutton, Surrey SM2 5PT, United Kingdom.
authors.forename: N M
authors.initials: NM
authors.lastname: de Souza
mesh_terms: D001859:Bone Neoplasms / Q000175:diagnosis* / Q000556:secondary; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009369:Neoplasms / Q000473:pathology / Q000628:therapy; D017063:Outcome Assessment, Health Care / Q000379:methods; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D019275:Radiopharmaceuticals
keywords: Bone; Cancer; EORTC; Imaging; MRI; Metastases; PET; RECIST; Response; Treatment