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Rong Y, Ren H, Ding X. MRI and Bone Scintigraphy for Breast Cancer Bone Metastase: A Meta-analysis. Open Med (Wars) 2019; 14:317-323. [PMID: 30931397 PMCID: PMC6434664 DOI: 10.1515/med-2019-0029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 01/09/2019] [Indexed: 11/15/2022] Open
Abstract
Objective The aim of this study was to compare the diagnostic value of magnetic resonance image (MRI) and bone scintigraphy (BS) in the diagnosis of breast cancer bone metastases. Methods Searching in the databases including PubMed, Embase about the comparative study of MRI and bone scintigraphy in the diagnosis of breast cancer bone metastases during 2000~2018. After we screened further, the extracted effective data were calculated by Meta-Disc 1.4 software. Results We obtained 4 articles. The pooled estimates for sensitivity of MRI, BS were 0.99 (95% CI, [0.95, 1.00]) and 0.93 (95% CI, [0.88, 0.97]) respectively; For specificity were 0.99 (95% CI, [0.95, 1.00]) and 0.86 (95% CI, [0.79, 0.92]) respectively. The AUC of SROC curve for MRI and BS were 0.9948 and 0.9675 respectively. Conclusion MRI remains to be a satisfactory method for the diagnosis of breast cancer bone metastases and should first be considered for patients.
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Affiliation(s)
- Yue Rong
- Department of Radiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, Hangzhou China
| | - Hong Ren
- Department of Radiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, Hangzhou China
| | - Xianjun Ding
- Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, Hangzhou China
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Rakheja R, Chandarana H, Ponzo F, Seltzer AL, Beltran LS, Geppert C, Friedman KP. Fluorodeoxyglucose positron emission tomography/magnetic resonance imaging: current status, future aspects. PET Clin 2013; 9:237-52. [PMID: 25030285 DOI: 10.1016/j.cpet.2013.10.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Simultaneous positron emission tomography (PET)/magnetic resonance (MR) imaging is a promising novel technology for oncology diagnosis and staging and neurologic and cardiac applications. Our institution's current research protocol results in a total imaging time of approximately 45 to 70 minutes with simultaneous PET/MR imaging, making this a feasible total body imaging protocol. Further development of MR-based attenuation correction will improve PET quantification. Quantitatively accurate multiparametric PET/MR data sets will likely improve diagnosis of disease and help guide and monitor the therapies for individualized patient care.
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Affiliation(s)
- Rajan Rakheja
- Department of Nuclear Medicine/Radiology, Royal University Hospital, Saskatoon, Saskatchewan, Canada.
| | - Hersh Chandarana
- Department of Radiology, New York University School of Medicine, 550 First Avenue, New York, NY, USA
| | - Fabio Ponzo
- Department of Radiology, New York University School of Medicine, 550 First Avenue, New York, NY, USA
| | - Alexandra L Seltzer
- Department of Radiology, New York University School of Medicine, 550 First Avenue, New York, NY, USA
| | - Luis S Beltran
- Department of Radiology, New York University School of Medicine, 550 First Avenue, New York, NY, USA
| | | | - Kent P Friedman
- Department of Radiology, New York University School of Medicine, 550 First Avenue, New York, NY, USA
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Whole-body diffusion-weighted imaging: is it all we need for detecting metastases in melanoma patients? Eur Radiol 2013; 23:3466-76. [DOI: 10.1007/s00330-013-2968-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Revised: 05/30/2013] [Accepted: 06/22/2013] [Indexed: 02/07/2023]
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Yang HL, Liu T, Wang XM, Xu Y, Deng SM. Diagnosis of bone metastases: a meta-analysis comparing ¹⁸FDG PET, CT, MRI and bone scintigraphy. Eur Radiol 2011; 21:2604-17. [PMID: 21887484 DOI: 10.1007/s00330-011-2221-4] [Citation(s) in RCA: 221] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Revised: 06/09/2011] [Accepted: 06/17/2011] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To perform a meta-analysis to compare (18)FDG PET, CT, MRI and bone scintigraphy (BS) for the diagnosis of bone metastases. METHODS Databases including MEDLINE and EMBASE were searched for relevant original articles published from January 1995 to January 2010. Software was used to obtain pooled estimates of sensitivity, specificity and summary receiver operating characteristic curves (SROC). RESULTS 67 articles consisting of 145 studies fulfilled all inclusion criteria. On per-patient basis, the pooled sensitivity estimates for PET, CT, MRI and BS were 89.7%, 72.9%, 90.6% and 86.0% respectively. PET=MRI>BS>CT. ("="indicated no significant difference, P > 0.05; ">" indicated significantly higher, P < 0.05). The pooled specificity estimates for PET, CT, MRI and BS were 96.8%, 94.8%, 95.4% and 81.4% respectively. PET = CT = MRI>BS. On per-lesion basis, the pooled sensitivity estimates for PET, CT, MRI and BS were 86.9%, 77.1%, 90.4% and 75.1% respectively. PET = MRI>BS>CT. The pooled specificity estimates for PET, CT, MRI and BS were 97.0%, 83.2%, 96.0% and 93.6% respectively. PET>MRI>BS>CT. CONCLUSION PET and MRI were found to be comparable and both significantly more accurate than CT and BS for the diagnosis of bone metastases.
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Affiliation(s)
- Hui-Lin Yang
- Department of Orthopaedics, The first affiliated hospital of Soochow University, No188, Shizi Street, Suzhou 215006, People's Republic of China.
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5
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A meta-analysis of 18FDG-PET, MRI and bone scintigraphy for diagnosis of bone metastases in patients with breast cancer. Skeletal Radiol 2011; 40:523-31. [PMID: 20495798 DOI: 10.1007/s00256-010-0963-8] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2010] [Revised: 04/26/2010] [Accepted: 04/28/2010] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To perform a meta-analysis comparing the diagnostic value of (18)FDG-PET, MRI, and bone scintigraphy (BS) in detecting bone metastases in patients with breast cancer. MATERIALS AND METHODS MEDLINE, EMBASE, Scopus, ScienceDirect, SpringerLink, Web of Knowledge, EBSCO, and the Cochrane Database of Systematic Review databases were searched for relevant original articles published from January 1995 to January 2010. Inclusion criteria was as follows: (18)FDG-PET, MRI or (99m)Tc-MDP BS was performed to detect bone metastases (the number of published CT studies was inadequate for meta-analysis and therefore could not be included in this study); sufficient data were presented to construct a 2 × 2 contingency table; histopathological analysis and/or close clinical and imaging follow-up for at least 6 months were used as the reference standard. Two reviewers independently assessed potentially eligible studies and extracted relevant data. A software program called "META-DiSc" was used to obtain the pooled estimates for sensitivity, specificity, diagnostic odds ratio (DOR), summary receiver operating characteristic (SROC) curves, and the *Q index for each modality. RESULTS Thirteen articles consisting of 23 studies fulfilled all inclusion criteria. On a per-patient basis, the pooled sensitivity estimates for MRI (97.1%) were significantly higher than those for PET (83.3%) and BS (87.0%; P <0.05). There was no significant difference between PET and BS (P <0.05). The pooled specificity estimates for PET (94.5%) and MRI (97.0%) were both significantly higher than those for BS (88.1%; P <0.05). There was no significant difference between PET and MRI (P >0.05). The pooled DOR estimates for MRI (298.5) were significantly higher than those for PET (82.1%) and BS (49.3%; P <0.05). There was no significant difference between PET and BS (P >0.05). The SROC curve for MRI showed better diagnostic accuracy than those for PET and BS. The SROC curve for PET was better than that for BS. The*Q index for MRI (0.935), PET (0.922), and BS (0.872) showed no significant difference (P ≥0.05). On a per-lesion basis, the pooled sensitivity estimates for BS (87.8%) were significantly higher than those for PET (52.7%; P <0.05). The pooled specificity estimates for PET (99.6%) were significantly higher than those for BS (96.1%; P <0.05).The pooled DOR estimates for PET (283.3) were significantly higher than those for BS (66.8%; P <0.05). The SROC curve for PET showed better diagnostic accuracy than that for BS. The*Q index for PET (0.941) was significantly higher than that for BS (0.893; P <0.05). CONCLUSION Magnetic resonance imaging was found to be better than (18)FDG-PET and BS for diagnosis of bone metastases in patients with breast cancer on a per-patient basis. On a per-lesion basis, (18)FDG-PET had lower sensitivity, higher specificity, a higher DOR, and a higher *Q index than BS.
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Balliu E, Boada M, Peláez I, Vilanova J, Barceló-Vidal C, Rubio A, Galofré P, Castro A, Pedraza S. Comparative study of whole-body MRI and bone scintigraphy for the detection of bone metastases. Clin Radiol 2010; 65:989-96. [DOI: 10.1016/j.crad.2010.07.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2009] [Revised: 03/16/2010] [Accepted: 07/14/2010] [Indexed: 11/30/2022]
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Osteoblastic response as a healing reaction to chemotherapy mimicking progressive disease in patients with small cell lung cancer. Eur Radiol 2008; 19:193-200. [DOI: 10.1007/s00330-008-1115-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2008] [Revised: 06/24/2008] [Accepted: 06/30/2008] [Indexed: 10/21/2022]
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Schmidt GP, Schoenberg SO, Schmid R, Stahl R, Tiling R, Becker CR, Reiser MF, Baur-Melnyk A. Screening for bone metastases: whole-body MRI using a 32-channel system versus dual-modality PET-CT. Eur Radiol 2006; 17:939-49. [PMID: 16951929 DOI: 10.1007/s00330-006-0361-8] [Citation(s) in RCA: 129] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2006] [Revised: 05/02/2006] [Accepted: 06/12/2006] [Indexed: 10/24/2022]
Abstract
The diagnostic accuracy of screening for bone metastases was evaluated using whole-body magnetic resonance imaging (WB-MRI) compared with combined fluorodeoxyglucose (FDG) positron emission tomography (PET) and computed tomography (CT) (FDG-PET-CT). In a prospective, blinded study, 30 consecutive patients (18 female, 12 male; 24-76 years) with different oncological diseases and suspected skeletal metastases underwent FDG-PET-CT as well as WB-MRI with the use of parallel imaging (PAT). With a 32-channel scanner, coronal imaging of the entire body and sagittal imaging of the complete spine was performed using T1-weighted and short tau inversion recovery (STIR) sequences in combination. PET-CT was conducted using a low-dose CT for attenuation correction, a PET-emission scan and diagnostic contrast-enhanced CT scan covering the thorax, abdomen and pelvis. Two radiologists read the MRI scans, another radiologist in combination with a nuclear medicine physician read the PET-CT scans, each in consensus. The standard of reference was constituted by radiological follow-up within at least 6 months. In 28 patients, 102 malignant and 25 benign bone lesions were detected and confirmed. WB-MRI showed a sensitivity of 94% (96/102), PET-CT exams achieved 78% (79/102; P<0.001). Specificities were 76% (19/25) for WB-MRI and 80% (20/25) for PET-CT (P>0.05). Diagnostic accuracy was 91% (115/127) and 78% (99/127; P<0.001), respectively. Cut-off size for the detection of malignant bone lesions was 2 mm for WB-MRI and 5 mm for PET-CT. WB-MRI revealed ten additional bone metastases due to the larger field of view. In conclusion, WB-MRI and FDG-PET-CT are robust imaging modalities for a systemic screening for metastatic bone disease. PAT allows WB-MRI bone marrow screening at high spatial resolution and with a diagnostic accuracy superior to PET-CT.
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Affiliation(s)
- Gerwin P Schmidt
- Department of Clinical Radiology, University Hospitals Grosshadern, Ludwig-Maximilians-University Munich, Marchioninistr. 15, 81377, München, Germany.
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Berberoğlu K, Unal SN, Kebudi R, Türkmen C, Cantez S. Role of 99mTc-hexakis-2-methoxyisobutylisonitrile for detecting marrow metastases in childhood solid tumours. Nucl Med Commun 2005; 26:1075-80. [PMID: 16264353 DOI: 10.1097/00006231-200512000-00005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
AIM To evaluate the role of 99mTc-hexakis-2-methoxyisobutylisonitrile (99mTc-MIBI) for detecting bone marrow metastases in childhood solid tumours, including lymphomas. METHODS Twenty-six children (18 males, eight females) were studied. They all had proven malignant solid tumours [Hodgkin's lymphoma (5), non-Hodgkin's lymphoma (3), neuroblastoma (9), Ewing's sarcoma (3), Langerhans cell histiocytosis (4), rhabdomyosarcoma (1) and germ cell tumour (1)] with suspected bone marrow metastases. All patients underwent computed tomography and/or magnetic resonance imaging, 99mTc-MIBI and Tc-methylene diphosphonate bone scans and bone marrow aspiration and/or biopsy. The scintigraphic evaluation of 99mTc-MIBI scans was performed according to the visual assessment of the extent and intensity of uptake. The scintigraphic score, which is the sum of the extent and intensity of uptake, was calculated for each patient. Scores of more than 2 were considered to be positive for bone marrow involvement. RESULTS Twenty-seven 99mTc-MIBI scans were studied for 26 patients. Twenty-two 99mTc-MIBI scans were accepted as normal bone marrow. Bone scans were also normal in these patients. Five of the 27 99mTc-MIBI scans had scores of more than 2. Bone marrow cytology revealed bone marrow metastases in these patients. CONCLUSION Abnormal 99mTc-MIBI uptake correlated extremely well with bone marrow aspiration/biopsy cytology results. Non-invasive 99mTc-MIBI imaging in children with malignant solid tumours appears to be promising for the evaluation of bone marrow metastases.
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MESH Headings
- Adolescent
- Biopsy
- Bone Marrow/pathology
- Child
- Child, Preschool
- Female
- Histiocytosis, Langerhans-Cell/diagnosis
- Histiocytosis, Langerhans-Cell/pathology
- Hodgkin Disease/diagnosis
- Hodgkin Disease/pathology
- Humans
- Infant
- Lymphoma, Non-Hodgkin/diagnosis
- Lymphoma, Non-Hodgkin/pathology
- Magnetic Resonance Spectroscopy
- Male
- Neoplasm Metastasis
- Neoplasms/diagnosis
- Neoplasms/pathology
- Neoplasms, Germ Cell and Embryonal/diagnosis
- Neoplasms, Germ Cell and Embryonal/pathology
- Neuroblastoma/diagnosis
- Neuroblastoma/pathology
- Nitriles/pharmacology
- Prospective Studies
- Radiopharmaceuticals/pharmacology
- Rhabdomyosarcoma/diagnosis
- Rhabdomyosarcoma/pathology
- Sarcoma, Ewing/diagnosis
- Sarcoma, Ewing/pathology
- Technetium Tc 99m Sestamibi/pharmacology
- Tomography, X-Ray Computed
- Whole-Body Counting
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Affiliation(s)
- Kezban Berberoğlu
- Nuclear Medicine Department, Faculty of Medicine, Istanbul University, Istanbul, Turkey
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10
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Ghanem N, Uhl M, Brink I, Schäfer O, Kelly T, Moser E, Langer M. Diagnostic value of MRI in comparison to scintigraphy, PET, MS-CT and PET/CT for the detection of metastases of bone. Eur J Radiol 2005; 55:41-55. [PMID: 15950100 DOI: 10.1016/j.ejrad.2005.01.016] [Citation(s) in RCA: 149] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2005] [Revised: 01/20/2005] [Accepted: 01/26/2005] [Indexed: 01/07/2023]
Abstract
The initial localization of metastases in the bone in patients with solid tumors has a relatively good prognosis in comparison with visceral metastasization. The early detection of bone marrow metastases allows for a rapid initiation of therapy and a subsequent reduction in the morbidity rate. Modern MRI is superior to the 30-year-old skeletal scintigraphy and bone marrow scintigraphy with respect to sensitivity, specificity, as well as the extent of osteal metastasis. MRI provides substantial, therapy-relevant additional information. MSCT plays an important role in the management of cancer patients in clinical routine and gives an excellent survey of the axial skeleton by demonstrating osteolytic and osteoblastic metastases. Extensive comparative studies of MRI with 18F-FDG-PET and 18F-fluoride-PET have not yet been carried out. Whole body MRI is a very promising new staging method for the oncological diagnosis of solid tumors and the detection of osteal metastases. The adoption of 18F-FDG-PET and 18F-fluoride-PET FDG as well as the side by side PET-CT image fusion and the two in one PET/CT examinations appears to be slightly less sensitive to whole body MRI in the detection of osteal metastases. Larger, prospective multicenter studies are necessary to establish these as new, promising methods for the detection of osteal metastases.
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Affiliation(s)
- N Ghanem
- Radiologische Klinik, Abt. Röntgendiagnostik, Universitätsklinikum Freiburg, Albert-Ludwigs-Universität Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany.
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11
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Andreula C, Murrone M. Metastatic disease of the spine. Eur Radiol 2005; 15:627-32. [PMID: 15696290 DOI: 10.1007/s00330-004-2627-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2004] [Accepted: 12/09/2004] [Indexed: 10/25/2022]
Abstract
Metastases of the spine occur in the spinal cord, dura extramedullary, epidural space, and vertebral bodies. Imaging modalities can be used to evaluate patient symptoms, screen and detect lesions, assess localization and the compartments involved (extradural, epidural, subdural, and paraspinal), and suggest therapeutic strategies. The suggested flow chart for metastases is (1) in asymptomatic patients suspected for metastases and (2) in the patient with neurological symptoms. Imaging modalities are indispensable in differential diagnosis because some nontumoral lesions can mimic metastases.
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Affiliation(s)
- Cosma Andreula
- Department of Neuroradiology and Radiology, Anthea Hospital, Bari and Citta di Lecce Hospital, Lecce, Puglia, Italy.
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Ghanem N, Kelly T, Altehoefer C, Winterer J, Schäfer O, Bley TA, Moser E, Langer M. [Whole-body MRI in comparison to skeletal scintigraphy for detection of skeletal metastases in patients with solid tumors]. Radiologe 2005; 44:864-73. [PMID: 15351930 DOI: 10.1007/s00117-004-1096-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The aim of this study was to compare the diagnostic efficacy of whole-body magnetic resonance imaging (WB-MRI) as a new and rapid examination technique with skeletal scintigraphy for detection of skeletal metastases from solid tumors. MATERIAL AND METHODS In 129 patients with solid malignant tumors, WB-MRI was performed for individual comparison with skeletal scintigraphy. Examinations were performed with the innovative AngioSURF rolling table with integrated phased array surface coil and coronary TIRM sequences for different body regions. RESULTS The results for WB-MRI and skeletal scintigraphy were concordant in 81% of the cases, whereby both procedures excluded skeletal metastases in 43%. WB-MRI and skeletal scintigraphy demonstrated skeletal metastases in 38% of the cases, whereby WB-MRI provided more comprehensive findings in 45%. In 12% of the cases, skeletal scintigraphy was superior to WB-MRI and in 19% the findings were discordant, whereby WB-MRI detected skeletal metastases in 15 cases which had not been found on skeletal scintigraphy. In nine cases, skeletal scintigraphy was positive when the WB-MRI was negative. In 60% of the cases, WB-MRI evidenced tumor-associated findings. CONCLUSION WB-MRI represents a promising new staging technique for detection of skeletal metastases, which is more sensitive in many cases than skeletal scintigraphy in detecting and assessing the extent of skeletal metastases-and tumor-associated findings that are relevant for treatment strategy.
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Affiliation(s)
- N Ghanem
- Abteilung Röntgendiagnostik, Radiologische Klinik der Albert-Ludwigs-Universität Freiburg.
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Mazumdar A, Siegel MJ, Narra V, Luchtman-Jones L. Whole-body fast inversion recovery MR imaging of small cell neoplasms in pediatric patients: a pilot study. AJR Am J Roentgenol 2002; 179:1261-6. [PMID: 12388510 DOI: 10.2214/ajr.179.5.1791261] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE. The purpose of this study was to assess the ability of whole-body turbo short tau inversion recovery (STIR) MR imaging to detect metastases in children with small cell tumors and to compare its performance with that of conventional imaging. CONCLUSION. Early data suggest that whole-body turbo STIR MR imaging is as reliable as other conventional imaging studies for staging newly diagnosed small cell tumors in pediatric patients.
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Affiliation(s)
- Avi Mazumdar
- Department of Radiology, Washington University School of Medicine, Mallinckrodt Institute of Radiology, 510 S. Kingshighway Blvd., St. Louis, MO 63110, USA
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Ghanem N, Altehoefer C, Högerle S, Schäfer O, Winterer J, Moser E, Langer M. Comparative diagnostic value and therapeutic relevance of magnetic resonance imaging and bone marrow scintigraphy in patients with metastatic solid tumors of the axial skeleton. Eur J Radiol 2002; 43:256-61. [PMID: 12204408 DOI: 10.1016/s0720-048x(01)00477-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE To evaluate the comparative impact of magnetic resonance imaging (MRI) and bone marrow scintigraphy (BMS) in bone marrow metastases of solid tumors. METHODS In 20 patients with solid tumors MRI of the axial skeleton and whole-body BMS were retrospectively reviewed. Detectability of metastases, extent of disease and therapeutic implications were assessed. RESULTS In 15/20 (75%) patients MRI and BMS concordantly revealed bone marrow metastases of the axial skeleton. In nine of these 15 patients (60%) MRI showed more metastases. Local radiotherapy or surgery was performed in seven of these cases (78%). BMS detected additional metastases of the appendicular skeleton in 8/15 (53%) patients. In 4/20 cases (20%) the imaging findings were discordant. In three patients with degenerative changes (n=2) or lipoma (n=1) BMS was false positive. In another patient BMS failed to detect metastases proven by MRI and clinical follow-up resulting in subsequent radiation therapy. One patient had normal bone marrow. CONCLUSION MRI appears to be more sensitive and specific in the detection of bone marrow metastases in the axial skeleton and is of clinical importance for subsequent local therapy.
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Affiliation(s)
- Nadir Ghanem
- Department of Diagnostic Radiology, University Hospital Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany.
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15
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van Meerbeeck JP. Staging of non-small cell lung cancer: consensus, controversies and challenges. Lung Cancer 2001; 34 Suppl 2:S95-107. [PMID: 11720749 DOI: 10.1016/s0169-5002(01)00356-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Stage is with performance status, the most potent prognostic factor in non-small cell lung cancer. In the past decades, much effort has been directed towards the definition, description, development and implementation of staging guidelines. This has undoubtedly resulted in improvements in therapy and insight in the biology of the disease. The new millennium sees us confronted with an increasing epidemic of lung cancer. Hence, the need for further improvements in staging accuracy and cost effectiveness, in order to use the available therapeutic armament at its best and provide the patient with a treatment that is best adjusted to his or her condition. Current controversies and future challenges in staging will be addressed.
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Affiliation(s)
- J P van Meerbeeck
- Rotterdam Oncological Thoracic Studygroup, University Hospital Rotterdam, Rotterdam, The Netherlands.
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Abstract
Defining the specific cause of pain in patients with cancer often has substantial therapeutic and prognostic implications. This process often requires the use of specific diagnostic investigations. Here we critically review the diagnostic investigations used in the evaluation of common pain problems in patients with cancer. Familiarity with this information facilitates the development of efficient and rational diagnostic strategies.
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Affiliation(s)
- N I Cherny
- Department of Medical Oncology, Shaare Zedek Medical Center, Jerusalem, Israel.
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