Factors Influencing Visualization of Vertebral Metastases on MR Imaging Versus Bone Scintigraphy

• Published in: American journal of roentgenology (1976) Vol. 176; no. 6; pp. 1525 - 1530
• Main Authors: Taoka, Toshiaki, Mayr, Nina A, Lee, Han J, Yuh, William T. C, Simonson, Teresa M, Rezai, Karim, Berbaum, Kevin S
• Format: Journal Article
• Language: English
• Published: Leesburg, VA Am Roentgen Ray Soc 01.06.2001; American Roentgen Ray Society
• Subjects: Biological and medical sciences; Female; Humans; Investigative techniques, diagnostic techniques (general aspects); Lumbar Vertebrae - diagnostic imaging; Lumbar Vertebrae - pathology; Magnetic Resonance Imaging; Male; Medical sciences; Middle Aged; Osteoarticular system. Muscles; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Radionuclide Imaging; Radiopharmaceuticals; Retrospective Studies; Spinal Neoplasms - diagnosis; Spinal Neoplasms - diagnostic imaging; Spinal Neoplasms - secondary; Technetium Tc 99m Medronate; Thoracic Vertebrae - diagnostic imaging; Thoracic Vertebrae - pathology; Radionuclide study; Human; Visualization; Diseases of the osteoarticular system; Vertebra; Spine disease; Malignant tumor; Metastasis; Scintigraphy; Nuclear magnetic resonance imaging; Medical imagery; Diagnosis; Detection; Comparative study
• ISSN: 0361-803X; 1546-3141
• DOI: 10.2214/ajr.176.6.1761525

The purpose of this study was to investigate whether the location and size of vertebral body metastases influence the difference in detection rates between MR imaging and bone scintigraphy. We retrospectively evaluated the vertebral body lesions detected on MR imaging in 74 patients with known widely disseminated metastatic disease. Three radiologists independently reviewed the MR images and bone scintigraphs. MR imaging findings included lesion size and its spatial relationship to the bony cortex (intramedullary, subcortical, and transcortical) and results were correlated with those of planar technetium 99m bone scintigraphy. Findings on bone scans were negative for all intramedullary lesions without cortical involvement shown on MR imaging, regardless of their size. Findings on bone scans (71.3% for transcortical and 33.8% for subcortical) were frequently positive for lesions with cortical involvement (trans- or subcortical), and the probability of positive findings on bone scans was also influenced by the lesion size. Statistical analysis showed a positive correlation among cortical involvement, lesion size, and positive findings on bone scintigraphy (p < 0.0001). Location (the presence of cortical bone involvement on MR imaging) and size of the vertebral body metastases appear to be important contributing factors to the difference in detection rates between MR imaging and bone scintigraphy. Cortical involvement is likely the cause of positive findings on bone scans. Early vertebral metastases tend to be small and located in the medullary cavity without cortical involvement, and therefore, findings may be positive on MR images but negative on bone scans.