Skip to main content
SpringerLink
Log in

Bone lesions on baseline staging rectal MRI: prevalence and significance in patients with rectal adenocarcinoma

  • Special Section: Rectal Cancer
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

A Correction to this article was published on 20 March 2021

This article has been updated

Abstract

A T1 sequence on routine baseline staging rectal magnetic resonance imaging (MRI) is thought to help detect bone lesions. Our primary aim was to evaluate the incidence of bone lesions encountered on baseline staging rectal MRI, particularly the prevalence of bone metastases. This retrospective study included patients with rectal adenocarcinoma who underwent baseline rectal MRI at our institution between January 2010 and December 2017. The MRI report was reviewed for presence of bone lesions. When found, lesion type, presence of axial T1 non-fat-suppressed sequence, primary tumor T-stage, and presence of other organ metastases were recorded. In the absence of bone biopsy, the reference standard was follow-up imaging via computed tomography (CT), MRI, and/or positron emission tomography/CT (PET/CT) ≥ 1 year after the baseline MRI. The Wilcoxon rank-sum test and Fisher's exact test were used to compare clinicopathologic data of patients with malignant or benign bone lesions. A total of 1197 patients were included. 62/1197 patients (mean age 56.8 years (SD: 13.8), with 39 men) had bone lesions on baseline imaging, with 6 being bone metastases (0.5%, 95% CI 0.2%–1.1%). Of the 6 patients with bone metastases, 5/6 had other metastases (i.e., liver, lung) at baseline. Bone metastases on baseline rectal MRI performed for rectal adenocarcinoma are extremely rare. Furthermore, bone metastases without other organ (i.e., liver, lung) involvement is extremely rare.

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

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Change history

References

  1. Meyer JE, Narang T, Schnoll-Sussman FH, Pochapin MB, Christos PJ, Sherr DL (2010) Increasing incidence of rectal cancer in patients aged younger than 40 years: an analysis of the surveillance, epidemiology, and end results database. Cancer 116 (18):4354-4359. https://doi.org/10.1002/cncr.25432

    Article  PubMed  Google Scholar 

  2. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A (2018) Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 68 (6):394-424. https://doi.org/10.3322/caac.21492

    Article  PubMed  Google Scholar 

  3. Ferlay J, Parkin DM, Steliarova-Foucher E (2010) Estimates of cancer incidence and mortality in Europe in 2008. Eur J Cancer 46 (4):765-781. https://doi.org/10.1016/j.ejca.2009.12.014

    Article  CAS  PubMed  Google Scholar 

  4. Sahni VA, Silveira PC, Sainani NI, Khorasani R (2015) Impact of a Structured Report Template on the Quality of MRI Reports for Rectal Cancer Staging. AJR Am J Roentgenol 205 (3):584-588. https://doi.org/10.2214/AJR.14.14053

    Article  PubMed  Google Scholar 

  5. Norenberg D, Sommer WH, Thasler W, D'Haese J, Rentsch M, Kolben T, Schreyer A, Rist C, Reiser M, Armbruster M (2017) Structured Reporting of Rectal Magnetic Resonance Imaging in Suspected Primary Rectal Cancer: Potential Benefits for Surgical Planning and Interdisciplinary Communication. Invest Radiol 52 (4):232-239. https://doi.org/10.1097/RLI.0000000000000336

    Article  PubMed  Google Scholar 

  6. Gollub MJ, Arya S, Beets-Tan RG, dePrisco G, Gonen M, Jhaveri K, Kassam Z, Kaur H, Kim D, Knezevic A, Korngold E, Lall C, Lalwani N, Blair Macdonald D, Moreno C, Nougaret S, Pickhardt P, Sheedy S, Harisinghani M (2018) Use of magnetic resonance imaging in rectal cancer patients: Society of Abdominal Radiology (SAR) rectal cancer disease-focused panel (DFP) recommendations 2017. Abdom Radiol (NY) 43 (11):2893-2902. https://doi.org/10.1007/s00261-018-1642-9

    Article  Google Scholar 

  7. Beets-Tan RGH, Lambregts DMJ, Maas M, Bipat S, Barbaro B, Curvo-Semedo L, Fenlon HM, Gollub MJ, Gourtsoyianni S, Halligan S, Hoeffel C, Kim SH, Laghi A, Maier A, Rafaelsen SR, Stoker J, Taylor SA, Torkzad MR, Blomqvist L (2018) Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting. Eur Radiol 28 (4):1465-1475. https://doi.org/10.1007/s00330-017-5026-2

    Article  PubMed  Google Scholar 

  8. NCCN Guidelines for Patients®: Rectal Cancer (2018) National Comprehensive Cancer Network. Rectal Cancer (Version 2.2018). https://www.nccn.org/patients/guidelines/content/PDF/rectal-patient.pdf. Accessed April 11 2020

  9. Disibio G, French SW (2008) Metastatic patterns of cancers: results from a large autopsy study. Arch Pathol Lab Med 132 (6):931-939. https://doi.org/10.1043/1543-2165(2008)132[931:MPOCRF]2.0.CO;2

    Article  PubMed  Google Scholar 

  10. Hess KR, Varadhachary GR, Taylor SH, Wei W, Raber MN, Lenzi R, Abbruzzese JL (2006) Metastatic patterns in adenocarcinoma. Cancer 106 (7):1624-1633. https://doi.org/10.1002/cncr.21778

    Article  PubMed  Google Scholar 

  11. Weiss L, Grundmann E, Torhorst J, Hartveit F, Moberg I, Eder M, Fenoglio-Preiser CM, Napier J, Horne CH, Lopez MJ, et al. (1986) Haematogenous metastatic patterns in colonic carcinoma: an analysis of 1541 necropsies. J Pathol 150 (3):195-203. https://doi.org/10.1002/path.1711500308

    Article  CAS  PubMed  Google Scholar 

  12. Baek SJ, Hur H, Min BS, Baik SH, Lee KY, Kim NK (2016) The Characteristics of Bone Metastasis in Patients with Colorectal Cancer: A Long-Term Report from a Single Institution. World J Surg 40 (4):982-986. https://doi.org/10.1007/s00268-015-3296-x

    Article  PubMed  Google Scholar 

  13. Roth ES, Fetzer DT, Barron BJ, Joseph UA, Gayed IW, Wan DQ (2009) Does colon cancer ever metastasize to bone first? a temporal analysis of colorectal cancer progression. BMC Cancer 9:274. https://doi.org/10.1186/1471-2407-9-274

    Article  PubMed  PubMed Central  Google Scholar 

  14. Katoh M, Unakami M, Hara M, Fukuchi S (1995) Bone metastasis from colorectal cancer in autopsy cases. J Gastroenterol 30 (5):615-618. https://doi.org/10.1007/BF02367787

    Article  CAS  PubMed  Google Scholar 

  15. Kanthan R, Loewy J, Kanthan SC (1999) Skeletal metastases in colorectal carcinomas: a Saskatchewan profile. Dis Colon Rectum 42 (12):1592-1597. https://doi.org/10.1007/BF02236213

    Article  CAS  PubMed  Google Scholar 

  16. Hwang S, Panicek DM (2007) Magnetic resonance imaging of bone marrow in oncology, Part 1. Skeletal Radiol 36 (10):913-920. https://doi.org/10.1007/s00256-007-0309-3

    Article  PubMed  Google Scholar 

  17. Bernard S, Walker E, Raghavan M (2017) An Approach to the Evaluation of Incidentally Identified Bone Lesions Encountered on Imaging Studies. AJR Am J Roentgenol 208 (5):960-970. https://doi.org/10.2214/AJR.16.17434

    Article  PubMed  Google Scholar 

  18. Schweitzer ME LC, Mitchell DG, Gannon FH, Gomella LG. (1993) Bull’s-eyes and halos: useful MR discriminators of osseous metastases. Radiology 188:249-252

    Article  CAS  PubMed  Google Scholar 

  19. Ghazizadeh S, Foss EW, Didier R, Fung A, Panicek DM, Coakley FV (2014) Musculoskeletal pitfalls and pseudotumours in the pelvis: a pictorial review for body imagers. Br J Radiol 87 (1042):20140243. https://doi.org/10.1259/bjr.20140243

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Simpfendorfer CS, Ilaslan H, Davies AM, James SL, Obuchowski NA, Sundaram M (2008) Does the presence of focal normal marrow fat signal within a tumor on MRI exclude malignancy? An analysis of 184 histologically proven tumors of the pelvic and appendicular skeleton. Skeletal Radiol 37 (9):797-804. https://doi.org/10.1007/s00256-008-0523-7

    Article  CAS  PubMed  Google Scholar 

  21. Nascimento D, Suchard G, Hatem M, de Abreu A (2014) The role of magnetic resonance imaging in the evaluation of bone tumours and tumour-like lesions. Insights Imaging 5 (4):419-440. https://doi.org/10.1007/s13244-014-0339-z

    Article  PubMed  PubMed Central  Google Scholar 

  22. Bangera S, Dunkow P, Weerasinghe S, Murugesan SV (2016) An unusual pain in the hip. Oxf Med Case Reports 2016 (9):omw072. https://doi.org/10.1093/omcr/omw072

    Article  Google Scholar 

  23. Udare A, Sable N, Kumar R, Thakur M, Juvekar S (2015) Solitary osseous metastasis of rectal carcinoma masquerading as osteogenic sarcoma on post-chemotherapy imaging: a case report. Korean J Radiol 16 (1):175-179. https://doi.org/10.3348/kjr.2015.16.1.175

    Article  PubMed  PubMed Central  Google Scholar 

  24. Chalkidou AS, Boutis AL, Padelis P (2009) Management of a Solitary Bone Metastasis to the Tibia from Colorectal Cancer. Case Rep Gastroenterol 3 (3):354-359. https://doi.org/10.1159/000239626

    Article  PubMed  PubMed Central  Google Scholar 

  25. Expert Panel on Gastrointestinal I, Fowler KJ, Kaur H, Cash BD, Feig BW, Gage KL, Garcia EM, Hara AK, Herman JM, Kim DH, Lambert DL, Levy AD, Peterson CM, Scheirey CD, Small W, Jr., Smith MP, Lalani T, Carucci LR (2017) ACR Appropriateness Criteria((R)) Pretreatment Staging of Colorectal Cancer. J Am Coll Radiol 14 (5S):S234-S244. https://doi.org/10.1016/j.jacr.2017.02.012

    Article  Google Scholar 

  26. Horvat N, Hope TA, Pickhardt PJ, Petkovska I (2019) Mucinous rectal cancer: concepts and imaging challenges. Abdom Radiol (NY) 44 (11):3569-3580. https://doi.org/10.1007/s00261-019-02019-x

    Article  PubMed Central  Google Scholar 

Download references

Acknowledgments

The authors thank Joanne Chin, MFA, ELS, for editorial support and Natalie Gangai for assistance on this article.

Funding

This research was funded in part by the NIH/NCI Cancer Center Support Grant P30 CA008748.

Author information

Authors and Affiliations

  1. Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA

    Jeffrey Levine, Iva Petkovska, Jonathan Landa, David D. B. Bates, J. Louis Fuqua III, Viktoriya Paroder, Marc J. Gollub & Jennifer S. Golia Pernicka

  2. Department of Radiology, Lenox Hill Hospital, 100 E 77th Street, New York, NY, 10075, USA

    Jeffrey Levine

  3. Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA

    Marinela Capanu & Junting Zheng

Authors
  1. Jeffrey Levine
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Iva Petkovska
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jonathan Landa
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. David D. B. Bates
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Marinela Capanu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. J. Louis Fuqua III
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Viktoriya Paroder
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Junting Zheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Marc J. Gollub
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Jennifer S. Golia Pernicka
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Conceptualization: JG, MG, IP, JL. Data curation: JL. Investigation: JL. Methodology: JL, JL, JG, IP, MG, MC, JZ. Formal analysis: JL, JG, MC, JZ. Project administration: JL, JG. Resources: N/A. Supervision: JG, IP. Visualization: JL, JG. Writing—original draft: JL. Writing—review & editing: JG, IP, MG, VP, DB, MC, JZ, LF.

Corresponding author

Correspondence to Jeffrey Levine.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee institutional review board at Memorial Sloan Kettering cancer Center and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

For this type of study formal consent is not required.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Levine, J., Petkovska, I., Landa, J. et al. Bone lesions on baseline staging rectal MRI: prevalence and significance in patients with rectal adenocarcinoma. Abdom Radiol 46, 2423–2431 (2021). https://doi.org/10.1007/s00261-020-02923-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-020-02923-7

Keywords

Search

Navigation