title: MRI findings of new uptake in the femoral head detected on follow-up bone scans.
abstract: OBJECTIVE. The purpose of this article is to suggest clinical indications for MRI in patients with breast cancer who have new uptake lesions in the femoral head on follow-up bone scans, by evaluating the incidence and causes of new uptake lesions. MATERIALS AND METHODS. Between January 2002 and July 2013, a total of 145 patients with breast cancer who showed new uptake in the femoral head on follow-up bone scans were included in our study. They were classified into two groups: group 1 consisted of 125 patients without known bone metastases, and group 2 consisted of 20 patients who already had bone metastases other than that in the femoral head. The Fisher exact test was performed for the statistical analysis. Thereafter, we reviewed MR images for characterization of the new abnormal uptake in the femoral head. RESULTS. New uptake lesions in the femoral head were metastatic in only 4.8% (6/125) of group 1 patients but in 75% (15/20) of group 2 patients (p < 0.0001). In both groups, no patient with a single uptake lesion in the femoral head had bone metastasis, whereas all patients with more than five new uptake lesions, including those of the femoral head, showed bone metastasis. Most MRI diagnoses for new uptake in the femoral head were fibrocystic change (15/30, 50%) and subchondral fracture (11/30, 36.7%). CONCLUSION. Most of the new uptake lesions in the femoral head detected on the follow-up bone scans in patients with breast cancer were benign. However, MRI could be considered in patients with known bone metastasis or with multiple new uptake lesions on bone scans.
authors.affiliation: 1 All authors: Department of Radiology, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea.
authors.forename: Seong Ho
authors.initials: SH
authors.lastname: Kim
authors.forename: Hye Jin
authors.initials: HJ
authors.lastname: Yoo
authors.forename: Yusuhn
authors.initials: Y
authors.lastname: Kang
authors.forename: Ja-Young
authors.initials: JY
authors.lastname: Choi
authors.forename: Sung Hwan
authors.initials: SH
authors.lastname: Hong
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology; D005266:Femoral Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000556:secondary; D005270:Femur Head / Q000000981:diagnostic imaging* / Q000473:pathology*; D005272:Femur Neck / Q000000981:diagnostic imaging* / Q000473:pathology*; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011877:Radionuclide Imaging; D012189:Retrospective Studies
keywords: MRI; bone scan; breast cancer; femur; metastasis