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Bone Metastases: Assessment of Therapeutic Response Using Radiological and Nuclear Medicine Imaging Modalities

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Bone Metastases

Part of the book series: Cancer Metastasis - Biology and Treatment ((CMBT,volume 21))

Abstract

Radiological and nuclear medicine imaging modalities that are used for evaluating the therapeutic response of metastatic bone disease include plain or digitalized radiography (XR), skeletal scintigraphy (SS), dual energy X-ray absorptiometry (DEXA), computed tomography (CT), magnetic resonance imaging (MRI), [18F] fluorodeoxyglucose positron emission tomography (FDG PET) and PET/CT. In this chapter we comment on the advantages and disadvantages of the aforementioned assessment modalities as seen through different clinical studies. Moreover, we present the well known response criteria described by the International Union Against Cancer (UICC) and World Health Organization (WHO) and the newer MDA (MD Anderson) criteria. In spite of the fact that serial XR and SS have been used for evaluating the treatment response for decades, changes are evident several months post therapy. Earlier response to treatment can be evaluated by using newer techniques such as the MRI or PET. Additionally therapeutic response may be quantified by monitoring changes in signal intensity (SI) and standard uptake value (SUV) respectively. PET/CT may be applied to follow both morphologic and metabolic changes in areas on skeletal metastases yielding interesting and promising results that reveal a new insight into the natural history of bone metastases. Due to the fact that only a few studies have investigated the use of these newer imaging modalities, further clinical trials are required to corroborate their promising results and establish the most appropriate imaging parameters and assessment time points. Finally, there is an absolute need to establish and adopt uniform response criteria for skeletal metastases through an international consensus in order to better evaluate therapeutic response in terms of accuracy and objectivity.

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Authors and Affiliations

  1. Department of Radiation Oncology, Bank of Cyprus Oncology Centre, Nicosia, Cyprus

    Vassilios Vassiliou M.D., Ph.D. & Dimitrios Andreopoulos

  2. Department of Radiology, Bank of Cyprus Oncology Centre, Nicosia, Cyprus

    Petros Polyviou & Dimitrios Andreopoulos

  3. Department of Nuclear Medicine, Bank of Cyprus Oncology Centre, Nicosia, Cyprus

    Savvas Frangos

  4. Department of Radiation Oncology, University of Patras Medical School, Patras, Greece

    Dimitrios Kardamakis

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  1. Vassilios Vassiliou M.D., Ph.D.
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  2. Petros Polyviou
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  3. Dimitrios Andreopoulos
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  4. Savvas Frangos
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  5. Dimitrios Kardamakis
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Correspondence to Vassilios Vassiliou M.D., Ph.D. .

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Editors and Affiliations

  1. Radiation Oncology, Bank of Cyprus Oncology Centre, Nicosia, Cyprus

    Vassilios Vassiliou

  2. Dept. Radiation Oncology, University of Toronto Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada

    Edward Chow

  3. Dept. Radiation Oncology, University of Patras Medical School, Patras, Greece

    Dimitrios Kardamakis

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Vassiliou, V., Polyviou, P., Andreopoulos, D., Frangos, S., Kardamakis, D. (2014). Bone Metastases: Assessment of Therapeutic Response Using Radiological and Nuclear Medicine Imaging Modalities. In: Vassiliou, V., Chow, E., Kardamakis, D. (eds) Bone Metastases. Cancer Metastasis - Biology and Treatment, vol 21. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-7569-5_21

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