- The Diagnostic Imaging of Bone Metastases
- Imaging of brain metastases
- The Diagnostic Imaging of Bone Metastases ()
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There was overall positive metabolic treatment response seen in the multiple fluorine fluorodeoxyglucose FDG avid osseous metastases, including in the bilateral ribs, thoracolumbar spine, sternum and pelvic bones Figure 6. This type of lung cancer is the most aggressive and rapidly growing of all types. Squamous cell carcinoma of the lung is strongly related to cigarette smoking, with only a small fraction of these tumors occurring in nonsmokers. This phenomenon can occur when the metastatic lesions are initially isodense to the surrounding skeleton and not detectable on the initial CT examination.
When the metastatic disease responds to chemotherapy, resultant osteoblastic reaction makes the lesions appear more sclerotic compared with the background density of the bones, thus becoming evident on the follow-up CT scan but mimicking development of new metastatic lesions. Availability of PET images improves accuracy of assessment, identifies the osseous metastases before actual morphologic appearance of the metastatic lesions on the initial examination, and appropriately categorizes them on follow-up images as responding to therapy.
He can be reached at munir. Tell us what you think about Healio. Login Register My Saved. Imaging Analysis Publication Exclusive. Please provide your email address to receive an email when new articles are posted on this topic. Receive an email when new articles are posted on this topic. You have already added this topic to your email alerts. Click here to manage your alerts. Munir Ghesani Similar partial anatomic and metabolic response was noted in the mediastinal and right hilar lymph node mass Figure 3 , with subsequent improvement of the obstructive changes in the right upper lobe Figure 4.
The Diagnostic Imaging of Bone Metastases
Positive treatment response is visible in the right supraclavicular lymph node, as shown in fused, soft tissue window CT and attenuation-corrected PET images. CT of malignant melanoma in the chest, abdomen, and musculoskeletal system. The halo sign in computed tomography images: differential diagnosis and correlation with pathology findings. All rights reserved.
For permissions, please email: journals. Issue Section:. Download all figures. View Metrics. Email alerts New issue alert. Advance article alerts. Article activity alert. Receive exclusive offers and updates from Oxford Academic. More on this topic Cannon ball pulmonary metastases. Needle tract pulmonary metastases. Multiple pulmonary nodules. Wegener's granulomatosis simulating pulmonary metastases. Development and usability evaluation of an online self-management intervention for fear of cancer recurrence iConquerFear.
Improving prognosis for early-stage Merkel cell carcinoma: trends from Digital tumor in a woman with metastatic melanoma. Citing articles via Google Scholar. Osteoporosis in this population was obvious on imaging. In addition, cancer can induce local osteoporosis . All of these factors can affect the detection and differential diagnosis of early-stage rib metastatic lesions, which mainly manifest as spots or nodules, as small patchy and poorly characterized low density shadows in the rib bone marrow on CT.
Imaging of brain metastases
The sensitivity and specificity of bone scintigraphy is also low for early small lesions . The sensitivity of MRI was significantly higher than bone scintigraphy and CT in our study, especially for small osteolytic lesions. The sensitivity, specificity and accuracy of MRI in the differential diagnosis between small osteolytic metastatic lesions and osteoporosis was relatively high, and these results are consistent with those of Baur-Melnyk and Reiser  , which focused on bone metastases in large bones in particular.
Another study  showed that the sensitivity of MRI for bone marrow changes was significantly higher than that of bone scintigraphy. MRI can detect lesions when cancer cells have just infiltrated the bone trabecular, before obvious osteolytic or osteoblastic changes appear. At present, some suggest that we should consider surgical treatment for solitary bone metastases from lung cancer, especially solitary rib metastasis in non-small cell lung cancer, as its prognosis tends to be better than that achieved with non-surgical management .
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In our study, a solitary rib metastasis was detected by CT in eight cases and by bone scintigraphy in 12, but all 30 cases were shown to have multiple rib metastases on MRI. This suggests that bone scintigraphy or CT scans for the preoperative screening of bone lesions is inappropriate and potentially inaccurate. The limitations of available imaging techniques may undermine the extent of bone lesions. The underlying mechanisms of bone metastases, including hematogenous or lymphatic spread, and the implantation of metastases makes it difficult to understand the occurrence of a solitary lesion, although it is possible that there are complex mechanisms that can cause solitary bone metastases.
The sample size of 55 cases 30 cases with definite metastases in our study was small, and therefore the results potentially lack adequate statistical significance.
Further studies with larger numbers are needed to validate our findings. The other limitations of our study include the selection bias as a consequence of the retrospective design of our study. Conceived and designed the experiments: X-WS. Wrote the paper: Y-QC. Revised the manuscript: X-WS. Browse Subject Areas? Click through the PLOS taxonomy to find articles in your field.
Abstract We retrospectively investigated the imaging findings of bone scintigraphy, chest CT and chest MRI in 55 cases of lung cancer.
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Funding: The authors have no support or funding to report. Introduction Lung cancer is the most common cause of cancer-related death among men and women worldwide  , . Materials and Methods Subjects Patients were assessed for inclusion who had been referred to our hospital with a histopathological diagnosis of lung cancer and who had undergone bone scintigraphy, CT scan or MRI imaging within the previous 4 weeks  , .
Imaging Analysis Images from the three imaging modalities were analyzed independently by six different radiologists. Results Of the 55 patients, 30 had a total of rib metastases Tables 1 , 2 , which were proven on clinical grounds, imaging and imaging follow-up follow-up period, 3—18 months. Download: PPT.
The Diagnostic Imaging of Bone Metastases ()
Table 1. Table 2. Detection of Rib Metastases with Bone Scintigraphy Twenty-eight patients with rib metastases and 62 metastatic rib lesions were correctly identified as true-positive findings by bone scintigraphy. Detection of Rib Metastases with CT Imaging When an observation section thickness of 5 mm was used, a total of 27 patients with rib metastases and a total of 65 metastatic rib lesions were correctly identified as true-positives by CT. Table 3. Distribution on a per-patient basis of different types of rib metastases in lung cancer, comparing 5 mm slice thickness and 1 mm slice thickness.
Table 4. Distribution on a per-lesion basis of different types of rib metastases in lung cancer, comparing 5 mm slice thickness and 1 mm slice thickness. Discussion On a per-patient basis, CT scans detected predominantly mixed changes Figure 1.
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The imaging manifestations of rib metastases in lung cancer, comparing 5 mm and 1 mm slice thickness on CT, and MRI. Figure 2. Minimal osteolytic changes: the initial manifestations of bone metastases and the primary stage of osteoblastic metastases. Figure 3. MRI in the detection and extent of osteoblastic metastatic lesions through direct and indirect signs. References 1. CA Cancer J Clin 10— View Article Google Scholar 2. CA Cancer J Clin 69— View Article Google Scholar 3. Lung Cancer — View Article Google Scholar 4. Int J Clin Pract —