Sherif Abdelfattah MD, PhD, Presenter: Nothing to Disclose

Osama Mohmed Raslan MD, Abstract Co-Author: Nothing to Disclose

The aim of work is to compare the ability of whole body MRI, with that of 99mTc-phosphonate-based scintigraphy to detect skeletal metastases in cancer patients and its impact upon treatment decision.

25 patients with pathologically proven primary malignant tumors were examined. Patients were referred from oncology and nuclear medicine departments, with pathologically proven primary malignant tumors and suspected or known skeletal metastatic disease. The patients were subjected to both Whole-Body MRI and Technetium 99m Methylene Diphosphonate bone scintigraphy (BS). WB-MRI was mainly obtained using 4 contiguous coronal stations for body coverage using the body coil, and 2 contiguous sagittal stations for the spine . Standard skeletal scintigraphy was performed using a planar one-phase technique (delayed phase).  

17 out of 25 cases had skeletal metastases, while 8 cases were free from metastases. When using data analysis based on region by region comparison the over all sensitivity, positive predictive value ,specificity, negative predictive value and accuracy for whole body MRI are 93.5%,100%,100%,97.2% and 98% respectively however for bone scan are 57.6%,95.7%,98.8%,83.4% and 86.1% respectively . WB-MRI had higher sensitivity ,specificity ,positive ,negative predictive value and accuracy than BS in detecting metastatic deposits at lumber, dorsal, cervical, sacral spine, pelvis and both extremities. Whole Body-Magnetic Resonant Imaging ( WB-MRI) was slightly better at the sternum and shoulder. Isotopic Bone Scintigraphy( BS) was better than WB-MRI in detecting metastatic deposits at the ribs, while both modalities were equal at the skull. Whole body MRI detected 35 tumor non related extra skeletal lesions. and 59 tumor related extraskeletal lesions .  

Whole body-Magnetic Resonant Imaging (WB-MRI) is a powerful and effective tool that showed higher sensitivity, specificity and accuracy than isotopic Bone Scintigraphy( BS) in various types of primary tumors and in various situations including solitary metastatic focus, diffuse extensive metastases and skeletal metastases from a second primary, needless to mention its uniqueness in staging of malignancies during pregnancy .   

WB-MRI is a powerful and effective tool that showed higher sensitivity, specificity and accuracy than  BS in detection of skeletal and extraskeletal deposits.  

Abdelfattah, S, Raslan, O, Diagnostic Value of Whole Body MRI  in Detection of Skeletal Metastases in Cancer Patients and Its Impact upon Treatment Decision.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9001833.html