Whole body MR imaging could replace bone scans in cancer patients

May 07, 2003

Whole body MR is superior to bone scans in determining how far cancer has spread into the bone marrow and bones, a new study shows.

The study compared whole body MR imaging and bone scans in the detection of bone metastases in patients with solid tumors, says Nadir Ghanem, MD, a resident at University Hospital Freiburg, department of diagnostic radiology, in Germany. The study is co-authored by Mathias Langer, MD, chair of the department of radiology. The MR examinations were performed using a rolling table platform, a so-called "bodysurf" which allowed for a broader view; the patients could be imaged nearly head to toe in a relatively short time, says Dr. Ghanem.

In 40 out of the 98 patients studied, skeletal metastatic disease was detected with both whole body MR imaging and a bone scan, says Dr. Ghanem. In 21 of these patients, MR imaging showed more extensive disease compared to bone scans, says Dr. Ghanem. In six patients, the bone scan showed more extensive disease in the arms, legs, and ribs, he notes. In 11 cases MR imaging detected skeletal metastases, but bone scans were negative.

In 80 of the 98 patients studied, MR imaging "yielded additional morphological information about the primary tumor, lymph node involvement, and visceral and soft tissue metastases," says Dr. Ghanem. "Whole body MR imaging was outstanding in predicting possible complications, such as fractures," says Dr. Ghanem.

Whole-body FDG-PET was performed on 45 of the 98 patients, says Dr. Ghanem. In 19 of the 45 patients the findings of MR imaging and PET were negative, and in 10 of these 45 both imaging techniques detected skeletal metastases, he says. However, in seven of the 10 patients with skeletal metastases, MR imaging was able to show more extensive metastatic disease. In six patients, the findings were not in agreement, and in five of these cases MR imaging was positive, while PET was negative. The positive MR imaging findings were proven by clinical follow-up, says Dr. Ghanem.

The MR examination takes less than 10 minutes; bone scans take between 15-20 minutes and PET scans of the entire body take 90 minutes, he says. In addition, the MR examination requires no radiation (no contrast media was used either); bone scans and PET scans require the use of a radioisotope.

"This particular study included 98 patients, but we have done more than 250 investigations using whole body MR imaging combined with a rolling table platform, says Dr. Ghanem.

The study will be presented May 7 during the American Roentgen Ray Society Annual Meeting in San Diego.
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Contact: Keri J. Sperry, 703-858-4306
Danica Laub, 703-858-4332
Press Room: 619-525-6536

American College of Radiology

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