title: Predictive value of pedicle involvement with MRI in spine metastases.
abstract: OBJECTIVE
  The study aimed to retrospectively evaluate the accuracy and value of magnetic resonance imaging (MRI) in predicting pedicle involvement for patients with spine metastases.
  
  
  METHODS
  Forty-five patients with a vertebral metastasis encroaching at least one pedicle were studied using MRI before surgery and regularly after surgery. Patients were categorized on the basis of their numbers of pedicle involvement (Group 1: one pedicle was involved, n = 23; Group 2: two pedicles were involved, n = 22). The diagnostic accuracy was calculated, and comparisons of intraoperative blood loss and recurrence rate between the two groups were performed.
  
  
  RESULTS
  The overall performance of MRI in predicting the pedicle involvement was as follows: accuracy, 94.4%; sensitivity, 95.5%; and specificity, 91.3%. Less intraoperative blood loss was observed for Group 1 compared with Group 2 (1,661 ± 672 ml and 2,173 ± 790 ml, respectively, P = 0.024). Tumor relapse occurred in 8.7% (2/23) of Group 1 and in 22.7% (5/22) of Group 2 with median recurrence free survival time 14 and 9 months, respectively.
  
  
  CONCLUSIONS
  MRI is a reliable approach to assess pedicle involvement. It has potential for use in the evaluation of the clinical characteristics of patients with spine metastases.
authors.affiliation: Department of Orthopedic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Wang Mi
authors.initials: WM
authors.lastname: Liu
authors.affiliation: Department of Orthopedic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Xing
authors.affiliation: Department of Orthopedic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Chong
authors.initials: C
authors.lastname: Bian
authors.affiliation: Department of Orthopedic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Liang
authors.affiliation: Department of Orthopedic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Libo
authors.initials: L
authors.lastname: Jiang
authors.affiliation: Department of Orthopedic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Qian
authors.affiliation: Department of Orthopedic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Dong
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D053208:Kaplan-Meier Estimate; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013125:Spinal Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary; D013131:Spine / Q000000981:diagnostic imaging* / Q000473:pathology
keywords: MRI; pedicle; spine metastases