Risonanza magnetica whole-body per l’identificazione delle metastasi scheletriche: confronto con la scintigrafia ossea

Abstract

WB-MRI is a reliable method for screening patients with suspected skeletal metastases, although BS still remains a useful tool. WB-MRI is also advantageous because it reveals extraskeletal and soft tissue metastases.

Diagnostic value of whole‐body magnetic resonance imaging for bone metastases: a systematic review and meta‐analysis

“…In the selected 11 studies, four studies conducted WB-MRI with DWI (22,27,(29)(30). The other studies conducted WB-MRI without DWI; seven studies used both histopathology and clinical follow-up as reference standards (20,22,23,25,27,(29)(30); three studies used only clinical follow-up evidence as the reference standard (24,27,28); one study used only clinical follow-up evidence as the reference standard (21). Of all 11 studies, five studies (23,(26)(27)(28)30) enrolled patients prospectively.…”

“…Five studies enrolled patients in a consecutive manner (20,23,27,29,30). For total scan time including patient positioning, six studies (20)(21)(22)(23)(24)28) were within 55 minutes, one study (27) was 75.8 minutes, and the others were not documented.…”

Radioisotope therapy of bone metastases

“…Unfortunately, scintigraphy clearly loses its value compared to MR-WBS [25][26][27][28]. However, scintigraphy sensitivity might be increased from 70% to over 80% by using SPECT technique.…”

Diagnostic accuracy and agreement between whole-body diffusion MRI and bone scintigraphy in detecting bone metastases

“…False negative findings and low sensitivity, on the other hand, may be caused by fast-growing lytic lesions, lesions with low metabolism or avascular anatomical sites. The role of conventional magnetic resonance (MR) imaging detecting bone metastases has long been established, and research is focusing on validating whole-body MR imaging for the staging of bone metastases [4][5][6]. This has prompted increasing interest in determining the real diagnostic impact of whole-body diffusion-weighted imaging (WB-DWI), compared with BS, in detecting bone metastases.…”

“…Le fratture e le alterazioni degenerative sono, causando turn-over metabolico dell'osso, le cause più frequenti di falsi positivi, comportando una riduzione della specificità della metodica; le lesioni litiche a rapido accrescimento, le lesioni a basso metabolismo, oppure quando la sede anatomica è avascolare, possono causare falsi negativi e quindi una riduzione di sensibilità. Il ruolo della risonanza magnetica (RM) convenzionale nei confronti della ricerca di metastasi ossee è consolidato da tempo e attualmente, l'interesse della letteratura si sta orientando verso la validazione della RM whole body nella stadiazione delle metastasi scheletriche [4][5][6]. È sorto, quindi, l'interesse nel capire quale possa essere il reale impatto diagnostico dell'imaging di diffusione whole-body rispetto alla scintigrafia ossea, nel riconoscere la presenza delle metastasi ossee.…”