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Keywords:
Musculoskeletal bone, Bones, Oncology, MR, CT, PET-CT, Biopsy, Diagnostic procedure, Cancer, Metastases, Haematologic diseases
Authors:
B. Lange1, M. L. Nielsen2, J. D. Andersen2, H. J. Lilholt2, M. Vyberg2, L. J. Petersen2; 1Hilleroed/DK, 2Aalborg/DK
DOI:
10.1594/ecr2015/B-0828
Purpose
Diagnostic imaging plays a major role in the evaluation of patients with skeletal tumors (1).
The majority of skeletal malignancies is represented by metastases.
The tumors that most often metastasize to bone are breast,
prostate,
lung,
kidney and thyroid carcinomas and about 75% of patients with these tumors will develop at least one bone metastasis (2); breast and prostate cancer account for more than 80% of cases of metastatic bone disease and cause the greatest morbidity (3).
Primary tumors are often associated with metastatic disease to bone even at initial diagnosis and complications are known to be pathological fracture,
pain,
cord compression,
spinal instability,
and hypercalcemia (1).
Since early detection is essential for precise distant staging,
optimal management,
and prevention of skeletal-related events,
information on diagnostic accuracy of imaging methods is vital for future imaging strategies.
Diagnostic imaging of skeletal malignancies can be performed by a variety of methods,
such as conventional X-Ray,
Computer Tomography (CT),
Magnetic Resonance Imaging (MRI),
Bone Scintigraphy (BS),
Single-Photon Emission Computed Tomography/CT (SPECT/CT) and Positron Emission Tomography–Computed Tomography (PET/CT).
Quality of data on accuracy of these modalities seem to be challenged by the variety of gold standards used,
ranging from clinical and imaging follow-up to bioptic pathology diagnosis (4,5).
The purpose of our study was to provide such data by retrospectively examining the diagnostic accuracy of standard skeletal imaging examinations of malignancy suspected skeletal changes using bioptic pathology diagnoses as the reference.