Murphy J, Rajakulasingam R, Iqbal A, Azzopardi C, Botchu R, Davies AM. The use of the flow-void sign on MRI: highly sensitive sign in detecting bone metastases from renal cell carcinoma.
Skeletal Radiol 2024;
53:917-922. [PMID:
37957342 DOI:
10.1007/s00256-023-04512-3]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/05/2023] [Accepted: 11/05/2023] [Indexed: 11/15/2023]
Abstract
OBJECTIVE
To evaluate a range of pathologically proven malignant bone tumours, including primary bone sarcoma and metastatic bone lesions, referred to a tertiary referral centre for the presence of the flow-void sign on MR imaging.
MATERIALS AND METHODS
A retrospective search was performed using the radiology information system and oncology database in our institution to identify patients over the age of 40 years referred with a solitary bone lesion. Patients with a range of pathologically proven malignant bone tumours, including primary bone tumours and metastatic bone lesions, were included in the study. MRI images were reviewed for the presence of the flow-void sign. The presence and type of the flow-void sign were correlated with lesion size.
RESULTS
Two hundred and sixty-six cases were included in the study. Overall, the flow-void sign was identified in 40.9% of cases. The flow-void sign was most frequently seen in renal cell carcinoma metastasis (90.0%). The sign is highly sensitive (90%) for renal cell carcinoma metastases with a high negative predictive value (98.09%). When the flow-void sign is identified, the lesion is almost three times more likely to represent a renal cell carcinoma metastasis than any other malignant tumour in patients over the age of 40 years with a solitary bone lesion.
CONCLUSION
The flow-void sign is highly sensitive for renal cell carcinoma bone metastases and could negate the need for biopsy in patients with a known history of renal cell carcinoma or in whom an occult renal cell carcinoma is subsequently identified.
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