title: [Imaging diagnostics in bone metastases].
abstract: Bone metastases are common, can cause a variety of relevant symptoms and are often associated with a poor prognosis. An early and accurate diagnosis is therefore crucial; however, the pattern is very heterogeneous and necessitates good knowledge of the possibilities and limitations of each imaging modality. Magnetic resonance imaging (MRI) and positron emission tomography-computed tomography (PET/CT) have the highest sensitivity and specificity for detecting bone metastases. Gradient echo and diffusion-weighted sequences are valuable supplements to the MRI protocol in doubtful cases and MRI is particularly suitable for distinguishing osteoporotic from metastatic spinal fractures with a high degree of diagnostic certainty; however, CT is the modality of choice for stability assessment. Reliable imaging parameters to predict therapy response in cases of bone metastases have not yet been elucidated in large clinical trials. The PET/MRI approach has shown promising preliminary results for diagnosis of bone metastases and further studies in larger cohorts are the subject of ongoing studies.
authors.affiliation: Diagnostische und Interventionelle Radiologie, Radiologische Klinik, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland. laurent.kintzele@med.uni-heidelberg.de.
authors.forename: L
authors.initials: L
authors.lastname: Kintzelé
authors.affiliation: Diagnostische und Interventionelle Radiologie, Radiologische Klinik, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland.
authors.forename: M-A
authors.initials: MA
authors.lastname: Weber
mesh_terms: D001859:Bone Neoplasms / Q000188:drug therapy* / Q000556:secondary*; D019317:Evidence-Based Medicine; D007089:Image Enhancement / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: Bone lesion; Bone metabolism; Bone stability; Spinal fracture; Treatment monitoring