ECR 2013 / C-0714
Spine Images for the Evaluation of Metastasis: Focused on Non-metastatic Lesions Mimicking Metastasis
Type:
Educational Exhibit
Keywords:
Metastases, Biopsy, MR, CT, Musculoskeletal spine, Neoplasia
Authors:
I. S. Lee1, Y. S. Song2, J. I. Moon3; 1Busan/KR, 2Pusan/KR, 3 Busan/KR
DOI:
10.1594/ecr2013/C-0714
Background
- We often examine the spine for evaluation of the presence of metastasis or the cause back pain in patients with extra-spinal malignant tumors.
The spine is the most common location for skeletal metastases,
accounting for approximately 39% of all bone metastases
- Typically,
metastases are multiple ill-defined lesions of variable size with cortical disruption.
These lesions may be osteolytic or osteosclerotic.
Vertebral compression fracture and epidural tumor are common in metastases.
- Clinical data,
such as patient age,
symptoms,
history,
and laboratory findings,
help make the radiologic diagnosis.
However,
in many cases,
clinical data are not specific,
with back pain being the most common complaint.
Moreover,
in the cases of patients with underlying malignant tumors,
most clinicians and radiologists preferentially consider bone metastases,
especially when multiple lesions are detected on evaluation of spine images
- The differentiation of non-metastatic lesions from metastases can have a significant impact on patient management,
especially in the cases of single lesion or the absence of metastatic lesions at other regions.
The imaging findings are characteristic in some lesions,
while others show indistinct findings.
Therefore,
the distinction between benign and malignant lesions or between infections and tumors is occasionally difficult.