Skip to main content
SpringerLink
Log in

Ganzkörper-MRT vs. Skelettszintigraphie bei der Detektion ossärer Metastasen solider Tumoren

Whole-body MRI in comparison to skeletal scintigraphy for detection of skeletal metastases in patients with solid tumors

  • Ganzkörper-MRT
  • Published:
Der Radiologe Aims and scope Submit manuscript

Zusammenfassung

Ziel

Vergleich des diagnostischen Stellenwerts der Ganzkörper-MRT (GK-MRT) als neues und schnelles Untersuchungsverfahren vs. Skelettszintigraphie (SKZ) bei der Erkennung ossärer Metastasen solider Tumoren.

Material und Methoden

Bei 129 Patienten mit soliden Malignomen wurde eine GK-MRT im intraindividuellen Vergleich mit der SKZ durchgeführt. Zum Einsatz kamen der innovative Angio-SURF®-Rolltisch mit integrierter Phased-array-Oberflächenspule und koronare TIRM-Sequenzen für verschiedene Körperregionen.

Ergebnisse

In 81% der Fälle lagen konkordante Befunde bei GK-MRT und SKZ vor, wobei in 43% beide Verfahren Skelettmetastasen ausschlossen. Bei 38% zeigten GK-MRT und SKZ Skelettmetastasen, wobei in 45% die GK-MRT ausgedehntere Befunde nachwies. Bei 12% war die SKZ der GK-MRT überlegen, bei 19% lagen diskordante Befunde vor, wobei die GK-MRT in 15 Fällen Skelettmetastasen bei negativer SKZ detektierte. In 9 Fällen war die SKZ positiv bei negativer GK-MRT. In 60% der Fälle wurden mit der GK-MRT tumorassozierte Befunde erhoben.

Schlussfolgerungen

Die GK-MRT stellt für die Detektion ossärer Metastasen ein vielversprechendes neues Stagingverfahren dar, welches in vielen Fällen sensitiver als die Skelettszintigraphie bzgl. des Nachweises und der Ausdehnung von Skelettmetastasen und therapeutisch relevanter Befunde ist.

Abstract

Purpose

The aim of this study was to compare the diagnostic efficacy of whole-body magnetic resonance imaging (WB-MRI) as a new and rapid examination technique with skeletal scintigraphy for detection of skeletal metastases from solid tumors.

Material and methods

In 129 patients with solid malignant tumors, WB-MRI was performed for individual comparison with skeletal scintigraphy. Examinations were performed with the innovative AngioSURF® rolling table with integrated phased array surface coil and coronary TIRM sequences for different body regions.

Results

The results for WB-MRI and skeletal scintigraphy were concordant in 81% of the cases, whereby both procedures excluded skeletal metastases in 43%. WB-MRI and skeletal scintigraphy demonstrated skeletal metastases in 38% of the cases, whereby WB-MRI provided more comprehensive findings in 45%. In 12% of the cases, skeletal scintigraphy was superior to WB-MRI and in 19% the findings were discordant, whereby WB-MRI detected skeletal metastases in 15 cases which had not been found on skeletal scintigraphy. In nine cases, skeletal scintigraphy was positive when the WB-MRI was negative. In 60% of the cases, WB-MRI evidenced tumor-associated findings.

Conclusion

WB-MRI represents a promising new staging technique for detection of skeletal metastases, which is more sensitive in many cases than skeletal scintigraphy in detecting and assessing the extent of skeletal metastases—and tumor-associated findings that are relevant for treatment strategy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2
Abb. 3
Abb. 4
Abb. 5

Literatur

  1. Abrams HL, Spiro R, Goldstein N (1950) Metastases in carcinoma: analysis of 1000 autopsied cases. Cancer 3:336–340

    Google Scholar 

  2. Adler CP, Herget G, Uhl M (2004) Knochenmetastasen. In: Adler CP, Herget G, Uhl M (Hrsg) Radiologische Diagnostik der Knochenkrankheiten. Springer, Berlin Heidelberg New York, S 166–170

  3. Altehoefer C, Ghanem N, Högerle S, Moser E, Langer M (2001) Comparative detectability of bone metastases and impact on therapy of magnetic resonance imaging and bone scintigraphy in patients with breast cancer. Eur J Radiol 40:16–23

    Article  CAS  PubMed  Google Scholar 

  4. Barkhausen J, Quick HH, Lauenstein T, Goyen M, Ruehm SG, Laub G, Debatin JF, Ladd ME (2001) Whole-body MR imaging in 30 seconds with real-time True FISP and a continously rolling table platform: feasibility study. Radiology 220:252–256

    CAS  PubMed  Google Scholar 

  5. Bathmann J, Moser E (1995) Vergleich von Skelettszintigraphie und Knochenmarkszintigraphie beim Nachweis ossärer Metastasen. Radiologe 35:8–14

    CAS  PubMed  Google Scholar 

  6. Daldrup-Link HE, Franzius C, Link TM, Laukamp D, Sciuk J, Jürgens H, Schober O, Rummeny EJ (2001) Whole-body MR imaging for detection of bone metastases in children and young adults: comparison with skeletal scintigraphy and FDG-PET. AJR Am J Roentgenol 177:229–236

    CAS  PubMed  Google Scholar 

  7. Engelhard K, Hollenbach HP, Wohlfart K, von Imhoff E, Fellner FA (2004) Comparison of whole-body MRI with automatic moving table technique and bone scintigraphy for screening in patients with breast cancer. Eur Radiol 14:99–105

    Article  CAS  PubMed  Google Scholar 

  8. Eustace SJ, Walker R, Blake M, Yucel EK (1999) Whole-body MR imaging: practical issues, clinical applications, and future directions. MRI Clin North Am 7:209–236

    Google Scholar 

  9. Eustace S, Tello R, DeCarvalho V, Carey J, Melhem E, Yucel EK (1997) A comparison of whole-body turboSTIR MR imaging and planar 99m Tc-methylene diphosphonate scintigraphy in the examination of patients with suspected skeletal metastases. AJR Am J Roentgenol 169:1665–1666

    Google Scholar 

  10. Ghanem N, Altehoefer C, Winterer J, Högerle S, Ghanem-Wiesel, Langer M (2002) Whole body-MRI in staging cancer patients: a comparison with whole-body FDG-PET. Cancer Imaging 3:18–19

    Google Scholar 

  11. Ghanem N, Altehoefer C, Schäfer O, Winterer J, Kelly T, Bley T, Langer M (2003) Whole-body MRI as a new screening and staging technique in detection of skeletal metastases in patients with solid tumors in comparison to skeletal scintigraphy and whole-body FDG-PET MRI. 2003 Garmisch 10th International MRI Symposium, p 85

  12. Ghanem NA, Altehoefer C, Winterer J, Högerle S, Scheffler K, Fautz HP, Langer M (2002) Whole-body MRI in staging lung carcinoma: a comparison with whole-body-FDG-PET. MAGMA 15:263

    Google Scholar 

  13. Ghanem NA, Fautz HP, Weigel MO, Speck O, Hennig J, Bley T, Langer M (2003) Whole body-MRI imaging with a continuously moving table platform in detection of metastatic disease in cancer patients: first results of a feasibility study. Proc Intl Soc Magn Reson Med 11:1333

    Google Scholar 

  14. Ghanem NA, Bley T, Springer O, Schäfer O, Thürl C, Langer M (2003) Whole body-MRI of bone marrow in patients with multiple myeloma and monoclonal gammopathy in comparison to plain films. Proc Intl Soc Magn Reson Med 11:696

    Google Scholar 

  15. Ghanem N, Altehoefer C, Högerle S, Schäfer O, Winterer J, Moser E, Langer M (2002) Comparative diagnostic value and therapeutic relevance of magnetic resonance imaging and bone marrow scintigraphy in patients with metastatic solid tumors of the axial skeleton. Eur J Radiol 43:256–261

    Article  PubMed  Google Scholar 

  16. Goyen M, Herborn CU, Kroger K, Lauenstein TC, Debatin JF, Ruehm SG (2003) Detection of atherosclerosis: systemic imaging for systemic disease with whole-body three-dimensional MR angiography—intial experience. Radiology 227:277–282

    PubMed  Google Scholar 

  17. Herborn CU, Goyen M, Quick HH, Bosk S, Massing S, Kroeger K, Stoesser D, Ruehm SG, Debatin JF (2004) Whole-body 3D MR angiography of patients with peripheral arterial occlusive disease. AJR Am J Roentgenol 182:1427–1434

    PubMed  Google Scholar 

  18. Iizuka-Mikami M, Nagai K, Yoshida K, Sugihara T, Suetsugu Y, Mikami M, Tamada T, Imai S, Kajihara Y, Fukunaga M (2004) Detection of bone marrow and extramedullary involvement in patients with non-Hodgkin’s lymphoma by whole-body MRI: comparison with bone and 67 Ga scintigraphies. Eur Radiol 14:1074–1081

    Article  PubMed  Google Scholar 

  19. Jacobson AF, Fogelman I (1998) Bone scanning in clinical oncology: does it have a future? Eur J Nucl Med 25:1219–1223

    Article  CAS  PubMed  Google Scholar 

  20. Layer G, Steudel A, Schüller H, van Kaick G, Grünwald F, Reiser M et al. (1999) MRI to detect bone marrow metastases in the initial staging of small cell lung carcinoma and breast carcinoma. Cancer 85:1004–1009

    Article  CAS  PubMed  Google Scholar 

  21. Lauenstein TC, Freudenberg LS, Goehde SC, Ruehm SG, Goyen M, Bosk S, Debatin JF, Barkhausen J (2002) Whole-body MRI using a rolling for detection of bone metastases. Eur Radiol 12:2091–2099

    PubMed  Google Scholar 

  22. Moser E (1990) Die Bedeutung der Skelettszintigraphie in der Nachsorge von Malignompatienten. Radiologe 30:465–471

    CAS  PubMed  Google Scholar 

  23. Nyström JS, Weiner JM, Heffeldinger-Juttner J (1977) Metastatic and histologic presentation in unknown primary cancer. Semin Oncol 4:53

    PubMed  Google Scholar 

  24. Ruehm SG, Goyen M, Barkhausen J, Kröger K, Bosk S, Ladd ME, Debatin JF (2001) Rapid magnetic resonance angiography for detection of atherosclerosis. Lancet 357:1086–1091

    Article  CAS  PubMed  Google Scholar 

  25. Schirrmeister H, Guhlmann A, Kotzerke J et al. (1999) Early detection and accurate description of extent of metastatic bone disease in breast cancer with fluoride ion and positron emission tomography. J Clin Oncol 17:2381–2389

    CAS  PubMed  Google Scholar 

  26. Schlemmer HPW, Pfannenberg C, Horger M, Wolfarth K, Tomaschko K, Hebart H, Fenchel M, Miller S, Clausen CD (2004) Clinical utility of a novel whole-body MRI system for comprehensive oncologic staging. Proc Intl Soc Magn Reson Med 12:2379

    Google Scholar 

  27. Steinborn M, Tilling R, Heuck A, Brügel M, Stäbler A, Reiser M (2000) Diagnostik der Metastasierung im Knochenmark mittels MRT. Radiologe 40:826–834

    Article  CAS  PubMed  Google Scholar 

  28. Steinborn MM, Heuck AF, Tiling R, Bruegel M, Gauger L, Reiser MF (1999) Whole-body bone marrow MRI in patients with metastastic disease to skeletal system. J Comput Assit Tomogr 23:123–129

    Article  CAS  Google Scholar 

  29. Tamada T, Nagai K, Iizuka M, Imai S, Kajihara Y, Yamamoto S, Kurebayashi J, Shimozuma K, Sonoo H, Fukunaga M (2000) Comparison of whole-body MR imaging and bone scintigraphy in the detection of bone metastases from breast cancer. Nippon Igaku Hoshasen Gakkai Zasshi 60:249–254

    CAS  PubMed  Google Scholar 

  30. Tausig A, Manthey N, Berger F, Sommer H, Pfluger T, Hahn K (2000) Vorzüge und Limitationen der Ganzkörper-Knochenmark-MRT mit Turbo-STIR-Sequenzen im Vergleich zur planaren Skelettszintigraphie. Nuklearmedizin 39:174–179

    CAS  PubMed  Google Scholar 

  31. Theissen P, Smolarz K, Scharl A et al. (1994) Kernspintomographie zum Metastasen-Screening? Ein prospektiver Vergleich mit der Skelettszintigraphie. Nuklearmedizin 33:132–137

    CAS  PubMed  Google Scholar 

  32. Walker RE, Eustace SJ (2001) Whole-body magnetic resonance imaging: techniques, clinical indications, and future applications. Semin Musculoskel Radiol 5:5–20

    Article  CAS  Google Scholar 

  33. Walker R, Kessar P, Blanchard K, Dimasi M, Harper K, DeCarvalho V, Yucel EK, Patriquin L, Eustace S (2000) Turbo STIR magnetic resonance imaging as a whole-body screening tool for metastases in patients with breast carcinoma: preliminary clinical experience. JMRI 11:343–350

    Article  CAS  PubMed  Google Scholar 

Download references

Interessenkonflikt:

Der korrespondierende Autor versichert, dass keine Verbindungen mit einer Firma, deren Produkt in dem Artikel genannt ist, oder einer Firma, die ein Konkurrenzprodukt vertreibt, bestehen.

Author information

Authors and Affiliations

  1. Abt. Röntgendiagnostik, Radiologische Klinik der Albert-Ludwigs-Universität Freiburg

    N. Ghanem, C. Altehoefer, J. Winterer, O. Schäfer, T. A. Bley & M. Langer

  2. Abt. Nuklearmedizin, Radiologische Klinik der Albert-Ludwigs-Universität Freiburg

    T. Kelly & E. Moser

  3. Abteilung Röntgendiagnostik, Radiologische Klinik der Albert-Ludwigs-Universität, Hugstetter Straße 55, 79106 , Freiburg

    N. Ghanem

Authors
  1. N. Ghanem
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. T. Kelly
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C. Altehoefer
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. Winterer
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. O. Schäfer
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. T. A. Bley
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. E. Moser
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. M. Langer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to N. Ghanem.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ghanem, N., Kelly, T., Altehoefer, C. et al. Ganzkörper-MRT vs. Skelettszintigraphie bei der Detektion ossärer Metastasen solider Tumoren. Radiologe 44, 864–873 (2004). https://doi.org/10.1007/s00117-004-1096-7

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00117-004-1096-7

Schlüsselwörter

Keywords

Search

Navigation