In patients with primary tumors that potentially metastasize to bone and primary malignant bone lesions, the diagnosis of bone metastasis is crucial to determine the prognosis and to optimize therapy. In patients with osteomyelitis multifocal appearance has to be evaluated. 99mTc-phosphonate-based skeletal scintigraphy is the standard method for the inital staging. MRI using Short tau inversion recovery sequences (STIR) has been found to be more sensitive for the detection of bone metastases compared to scintigraphy in adults [1]. This study was performed to compare whole-body...

44 children and adolescents who received a whole-body MRI usinga STIR sequence were included into thestudy. MRI was necessary in cause of inflammatory bone lesions and in cases of malignant bone lesions. Only in23 patients (12 boys, 11 girls) corresponding MRI and Scintigraphy could be evaluated (7patients with inflammatory lesions; 16patients with malignant lesions) - inclusion criteria was a time interval of 5 weeks maximal between scintigraphyand the MRI examination.In 8 patients follow-up corresponding MRI and scintigraphic investigations could be analyzed. Conventional whole-body Scintigraphy was...

Both MRI and scintigraphic imaging were well tolerated by all patients. All examinations were considered diagnostic. Including all examinations (baseline and follow-up investigations) scintigraphy detected bone lesions in 96 regions, whole-body MRI in 240 regions. Baseline MRIrevealed 78 bone lesions in 256 sites in 16 patients with malignancies, scintigraphy revealed only 37 lesions.Exact correlation between both modalities was observed only in 4 patients (25%). Discrepancies were found in 12 patients (75%). Correlation between both methods according to the lesion site was observed in 33 regions....

The results suggest that whole-body MR imaging using a STIR-TSE sequence is an effective radiation-free method for examining children with suspected multifocal bone lesions. In our study, whole-body STIR showed more lesions than conventional 99mTc-methylene diphosphonate planar scintigraphy especially in malignancies. So, whole-body MRI can be used as a screening modality for metastatic and skip lesions in sarcoma, PNET, Ewing sarcoma, Histiocytosis X. MRI is known to be very sensitive for imaging of bone marrow disorders, and as metastatic cancer is primarily a disease of...

[1] Eustace S, Tello R, De Carvalho V et al. A comparison of whole-body turbo STIR MR imaging and planar 99m Tc-methylene diphosphonate scintigraphy in the examination of patients with suspected skeletal metastases. AJR 1997; 169: 1655-1661. [2] Haubold-Reuter BG, Duewell S, Schilcher BR et al. The value of bone scintigraphy, bone marrow scintigraphy and fast spin-echo magnetic resonance imaging in staging of patients with malignant solid tumors: a prospective study. Eur Nucl Med 1993; 20: 1063-1069.

Hans-J. Mentzel,Christina Fleischmann, Dieter Sauner, Clemens Fitzek, Martin Freesmeyer, Susanna Vogt, Werner A. Kaiser - Institut fr Diagnostische und Interventionelle Radiologie, Friedrich-Schiller-Universitt Jena, Bachstrae 18, 07740 JenaDietmar Gottschild, Klinik fr Radiologie, Abteilung fr Nuklearmedizin, Bachstrae 18, 07740 JenaKarim Kentouche, Felix Zintl - Klinik fr Kinder- und Jugendmedizin, Friedrich-Schiller-Universitt Jena, Bachstrae 18, 07740 Jenawww.med.uni-jena.de