title: Anatomic and functional imaging in the diagnosis of spine metastases and response assessment after spine radiosurgery.
abstract: Spine stereotactic radiosurgery (SSRS) has recently emerged as an increasingly effective treatment for spinal metastases. Studies performed over the past decade have examined the role of imaging in the diagnosis of metastases, as well as treatment response following SSRS. In this paper, the authors describe and review the utility of several imaging modalities in the diagnosis of spinal metastases and monitoring of their response to SSRS. Specifically, we review the role of CT, MRI, and positron emission tomography (PET) in their ability to differentiate between osteoblastic and osteolytic lesions, delineation of initial bony pathology, detection of treatment-related changes in bone density and vertebral compression fracture after SSRS, and tumor response to therapy. Validated consensus guidelines defining the imaging approach to SSRS are needed to standardize the diagnosis and treatment response assessment after SSRS. Future directions of spinal imaging, including advances in targeted tumor-specific molecular imaging markers demonstrate early promise for advancing the role of imaging in SSRS.
authors.affiliation: Departments of1Radiation Oncology and.
authors.forename: Moaaz
authors.initials: M
authors.lastname: Soliman
authors.affiliation: Departments of2Radiation Oncology and.
authors.forename: Neil K
authors.initials: NK
authors.lastname: Taunk
authors.affiliation: Departments of1Radiation Oncology and.
authors.forename: Robert E
authors.initials: RE
authors.lastname: Simons
authors.affiliation: 3Radiology, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Osborne
authors.affiliation: Departments of1Radiation Oncology and.
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Kim
authors.affiliation: 4Neurosurgery, University of Michigan Cancer Center, Ann Arbor, Michigan; and.
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Szerlip
authors.affiliation: Departments of1Radiation Oncology and.
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Spratt
mesh_terms: D005260:Female; D050815:Fractures, Compression; D006801:Humans; D008297:Male; D059906:Neuroimaging; D016634:Radiosurgery / Q000379:methods*; D015203:Reproducibility of Results; D013125:Spinal Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary / Q000601:surgery*; D016896:Treatment Outcome
keywords: ADC = apparent diffusion coefficient; DCE-MRI = dynamic contrast-enhanced MRI; DWI = diffusion-weighted imaging; MDA = MD Anderson; PET = positron emission tomography; RECIST = Response Evaluation Criteria in Solid Tumors; RT = radiation therapy; SPINO = Spine Response Assessment in Neuro-Oncology; SSRS = spine stereotactic radiosurgery; STIR = short tau inversion recovery; VCF = vertebral compression fracture; imaging; spine metastases; stereotactic body radiotherapy; treatment response