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The value of bone scintigraphy, bone marrow scintigraphy and fast spin-echo magnetic resonance imaging in staging of patients with malignant solid tumours: a prospective study

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Abstract

The purpose of this prospective study was to define the value of bone scintigraphy (BS), bone marrow scintigraphy (BMS) and the new fast spin-echo (FSE) magnetic resonance imaging (MRI) sequences in screening for bone metastases in patients with solid malignant tumours. It was our particular interest to classify patients into a group with and a group without bone metastases, and not only to compare the absolute number of metastases detected by each method. Thirty-two patients were examined using technetium-99m dicarboxy propane diphosphonate bone scintigraphy, 99mTc-labelled monoclonal anti-granulocyte antibodies for bone marrow scintigraphy and 1.5 T MRI using T1-weighted and FSE T2-weighted sequences. Against a reference standard obtained by re-evaluation of all clinical and imaging data 1 year after prospective BS, BMS and MRI had been performed, the three imaging modalities were falsely positive in two, eight and two cases and falsely negative in zero and four cases, respectively. BMS was falsely positive in eight patients because of vertebral marrow degeneration which caused photopenic defects which could not be differentiated from metastases. MRI showed these lesions to unequivocally contain fat. BMS and MRI were falsely negative in four cases because of the limited field of examination. In our study the key factor in classifying a patient as bone MI or MO was the possibility of surveying the entire skeleton, as is the case in BS, and not that MRI had a higher sensitivity compared to BS when analysis was on a lesion-by-lesion basis. BMS had the same limitations as MRI because the usual bone marrow distribution resulted in a “physiologically” limited field of view. We conclude that BS remains the method of choice in staging patients with solid tumours despite the fact that MRI is no longer a time-consuming method using FSE sequences. MRI has a complemantary role if special questions remain. BMS appears to have little value in the detection of bone metastases because of its poor specificity, its limited spatial resolution and its restriction to those areas of the skeleton containing haematopoietic marrow.

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References

  1. McNeil BJ. Value of bone scanning in neoplastic disease. Semin Nucl Med 1984;14: 277–286

    Google Scholar 

  2. Krishnamurthy GT, Tubis M, Hiss J, Bkand WH. Distribution pattern of metastatic bone disease: a need for total body skeletal imaging: JAMA 1977;237: 2504–2506

    Google Scholar 

  3. Daffner RH, Lupetin AR, Dash N, Deeb ZL, Sefczek RJ, Schapiro RL. MRI in the detection of malignant infiltration of bone marrow. AJR 1986;146: 353–358

    Google Scholar 

  4. Dooms GC, Fisher MR, Hricak H, Richardson M, Crooks LE, Genant HK. Bone marrow imaging: magnetic resonance studies related to age and sex. Radiology 1985;155: 429–432

    Google Scholar 

  5. Hajek PC, Baker LL, Goobar JE, et al. Focal fat deposition in axial bone marrow: MR characteristics. Radiology 1987;162:245–249

    Google Scholar 

  6. Porter BA, Shields AF, Olson DO. Magnetic resonance imaging of bone marrow disorders. Radiol Clin North Am 1986;24: 269–289

    Google Scholar 

  7. Vogler III JB, Murphy WA. Bone marrow imaging. Radiology 1988;168: 679–693

    Google Scholar 

  8. Delbeke D, Powers TA, Sandler MP. Correlative radionuclide and magnetic resonance imaging in evaluation of the spine. Clin Nucl Med 1989;14: 742–749

    Google Scholar 

  9. Batson OV The role of the vertebral veins and their role in the spread of metastasis. Ann Surg 1940;112: 138–149

    Google Scholar 

  10. Batson OV. The function of the vertebal veins in metastatic processes. Ann Intern Med 1942;16: 38–45

    Google Scholar 

  11. Berrettoni BA, Carter JR. Current concepts review. Mechanisms of cancer metastasis to bone. J Bone Joint Surg [Am] 1986;68: 308–312

    Google Scholar 

  12. Algra PR, Bloem JL, Tissing H, Falke TH, Arndt JW, Verboom LJ. Detection of vertebral metastases: comparison between MR imaging and bone scintigraphy. Radiographics 1991;11: 219–232

    CAS  PubMed  Google Scholar 

  13. Avrahami E, Tadmor R, Dally O, Hadar H. Early MR demonstration of spinal metastases in patients with normal radiographs and CT and radionuclide bone scan. J Comput Assist Tomogr 1989;13: 598–602

    Google Scholar 

  14. Bauer R, Van de Flierdt E, Langhammer HR, Allgayer B, Stepan R. Szintigraphie und Kernspintomographie des Skeletts und Knochenmarks. Der Nuklearmediziner 1989;5: 303–320

    Google Scholar 

  15. Kattapuram SV, Khurana JS, Scott JA, El-Khoury GY. Negative scintigraphy with positive magnetic resonance imaging in bone metastases. Skeletal Radiol 1990;19: 113–116

    Google Scholar 

  16. Khurana JS, Rosenthal DI, Rosenberg AE, Mankin HJ. Skeletal metastases in liposarcoma detectable only by magnetic resonance imaging. Clin Orthop 1989;243: 204–207

    Google Scholar 

  17. Mehta RC, Wilson MA, Perlmann SB. False negative bone scan in extensive metastatic disease: CT and MR findings. J Comput Assist Tomogr 1989;13: 717–719

    Google Scholar 

  18. Duncker CM, Carrio I, Berna L, et al. Radioimmune imaging of bone marrow in patients with suspected bone metastases from primary breast cancer. J Nucl Med 1990;31: 1450–1455

    Google Scholar 

  19. Munz DL, Sandrock D, Rillinger N. Comparison of immunoscintigraphy and colloid scintigraphy of bone marrow [letter]. Lancet 1990;1: 258

    Google Scholar 

  20. Reske SN. Recent advances in bone marrow scanning. Eur J Nucl Med 1991;18: 203–221

    Google Scholar 

  21. Linden A, Schauerte G, Theissen P, Waters W, Diehl V, Schicha H. Unterschiedliche Wertigkeit von Szintigraphie und Kernspintomographie des Knochenmarkes bei verschiedenen malignen lymphatischen Erkrankungen. Der Nuklearmediziner 1989;5: 343–351

    Google Scholar 

  22. Hotze A, Ruhlmann J, Bockisch A, Briele B, Biersack J. Vergleich der Knochenmarkszintigraphie und Magnetresonanztomographie beim Plasmocytom. Der Nuklearmediziner 1989;5: 337–341

    Google Scholar 

  23. Schwarz A, Steinstrasser A. A novel approach to 99m-Tc-labelled monoclonal antibodies [Abstract]. J Nucl Med 1987;28: 721

    Google Scholar 

  24. Haubold-Reuter B, Duewell S, Schilcher B, Marincek B, von Schulthess GK. Fast spin echo MRI and bone scintigraphy in the detection of skeletal metastases. Eur Radiology 1993

  25. Bohndorf K. Knochenmetastasen. In: Bohndorf K, ed. R-Tomographie des Skellets und der peripheren Weichteile. Berlin Heidelberg New York: Springer; 1991: 71–74

    Google Scholar 

  26. Frank JA, Ling A, Patronas NJ, et al. Detection of malignant bone tumors: MR imaging versus scintigraphy. AJR 1990;155: 1043–1048

    Google Scholar 

  27. McKillop JH. Bone scanning in metastatic disease. In: Fogelman I, ed. Bone scanning in clinical practice. Berlin Heidelberg New York: Springer; 1987: 41–60

    Google Scholar 

  28. McKillop JH. Bone scanning in primary bone tumours and marrow disorders. In: Fogelman I, ed. Bone scanning in clinical practice. Berlin Heidelberg New York: Springer; 1987:61–72

    Google Scholar 

  29. Datz FL, Taylor A Jr. The clinical use of radionuclide bone marrow imaging. Semin Nucl Med 1985;XV, No 3

  30. Reske SN, Gloeckner W Schwarz A, et al. Radioimmunoimaging for diagnosis of bone marrow involvement in breast cancer malignant lymphoma. Lancet 1988;11: 299–301

    Google Scholar 

  31. Fritz P, Adolph J, Bubeck B, Georgi P, zum Winkel K. Knochenmarksszintigraphie mit Radiokolloiden bei Skelettmetastases. Fortschr Röntgenstr 1986;144: 689–695

    Google Scholar 

  32. Otsuka N, Fugunaka M, Sone T, et al. The usefulness of bone-marrow scintigraphy in the detection of bone metastases from prostatic cancer. Eur J Nucl Med 1985;11: 319–322

    Google Scholar 

  33. Hotze A, Löw A, Mahlstedt J, Wolf F. Kombinierte Knochenmark-und Skelettszintigraphy bei ossären und myelogenen Erkrankungen. Fortschr Röntgenstr 1984;140: 717–723

    Google Scholar 

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Author notes

  1. B. G. Haubold-Reuter

    Present address: Department of Medical Radiology, University of Hamburg, Hamburg, Germany

Authors and Affiliations

  1. Division of Radiology, Department of Medical Radiology, Universitätsspital Zurich, Rämistrasse 100, CH-8091, Zürich, Switzerland

    B. G. Haubold-Reuter, S. Duewell & B. Marincek

  2. Division of Radiation Oncology, Department of Medical Radiology, Universitätsspital Zurich, Ramistrasse 100, CH-8091, Zurich, Switzerland

    B. R. Schilcher

  3. Division of Nuclear Medicine, Department of Medical Radiology, Universitätsspital Zurich, Rämistrasse 100, CH-8091, Zürich, Switzerland

    G. K. V. Schulthess

Authors
  1. B. G. Haubold-Reuter
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  2. S. Duewell
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  3. B. R. Schilcher
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  4. B. Marincek
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  5. G. K. V. Schulthess
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Correspondence to: G.K. v. Schulthess

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Haubold-Reuter, B.G., Duewell, S., Schilcher, B.R. et al. The value of bone scintigraphy, bone marrow scintigraphy and fast spin-echo magnetic resonance imaging in staging of patients with malignant solid tumours: a prospective study. Eur J Nucl Med 20, 1063–1069 (1993). https://doi.org/10.1007/BF00173484

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  • DOI: https://doi.org/10.1007/BF00173484

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