title: [Vertebral metastases of urogenital carcinomas: Diagnosis and conservative therapy].
abstract: The high incidence of bone metastases of urologic neoplasms and their morbidity, especially of vertebral metastases, requires exact diagnosis and consequent therapy. Conventional radiography plays an important role in the diagnosis of symptomatic bone lesions. Computed tomography can evaluate the stability of metastatic lesions and is indispensable for therapy planning. MRI and PET-CT have the highest diagnostic accuracy for the detection of bone metastases and MRI can evaluate their intra- and extraosseus components. PET-CT, PET-MRI, or SPECT-CT in combination with specific tracers - due to their high specificity and sensitivity - have the potential to replace conventional methods in the future. Conservative treatment basically consists of analgesic therapy, the administration of calcium and vitamin D3 and bisphosphonates or inhibitors of RANKL (denosumab). Moreover radium-223-dichloride can improve overall survival and the time to the first symptomatic skeletal event in castration-resistant prostate cancer patients with bone metastases.
authors.affiliation: Urologische Universitätsklinik Erlangen, Universitätsklinikum Erlangen, Krankenhausstraße 12, 91054, Erlangen, Deutschland. bastian.keck@uk-erlangen.de.
authors.forename: B
authors.initials: B
authors.lastname: Keck
authors.affiliation: Radiologisches Institut, Universitätsklinikum Erlangen, Erlangen, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Hammon
authors.affiliation: Radiologisches Institut, Universitätsklinikum Erlangen, Erlangen, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Uder
authors.affiliation: Klinik und Poliklinik für Urologie, Medizinische Fakultät Carl Gustav Carus, TU Dresden, Dresden, Deutschland.
authors.forename: J
authors.initials: J
authors.lastname: Huber
authors.affiliation: Urologische Universitätsklinik Erlangen, Universitätsklinikum Erlangen, Krankenhausstraße 12, 91054, Erlangen, Deutschland.
authors.forename: P J
authors.initials: PJ
authors.lastname: Goebell
authors.affiliation: Urologische Universitätsklinik Erlangen, Universitätsklinikum Erlangen, Krankenhausstraße 12, 91054, Erlangen, Deutschland.
authors.forename: F
authors.initials: F
authors.lastname: Kunath
authors.affiliation: Urologische Universitätsklinik Erlangen, Universitätsklinikum Erlangen, Krankenhausstraße 12, 91054, Erlangen, Deutschland.
authors.forename: B
authors.initials: B
authors.lastname: Wullich
authors.affiliation: Orthopädische Universitätsklinik Erlangen, Friedrich-Alexander-Universität Erlangen, Erlangen, Deutschland.
authors.forename: R H
authors.initials: RH
authors.lastname: Richter
mesh_terms: D000700:Analgesics / Q000008:administration & dosage*; D050071:Bone Density Conservation Agents / Q000008:administration & dosage*; D003952:Diagnostic Imaging / Q000379:methods; D019317:Evidence-Based Medicine; D006801:Humans; D011878:Radiotherapy / Q000379:methods; D013125:Spinal Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000628:therapy*; D016896:Treatment Outcome; D014571:Urologic Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy*
chemical_list: D000700:Analgesics; D050071:Bone Density Conservation Agents
keywords: Bone lesions, symptomatic; Denosumab; Radium 223 dichloride; Vertebral metastases; Zoledronic-acid