Improved Radiotherapy Planning and Follow-Up of Bone Metastases by Skeletal Ultrasound

Abstract

In oncology ultrasound has become an established imaging method for the diagnosis, follow-up, and posttherapeutic care of most parenchymal organs and has gained growing importance; its application to tumors of the skeletal system, on the other hand, is still very uncommon. Kratochwil’s outstanding report on the prospect for ultrasound diagnosis in primary bone tumors [1] unfortunately remained widely unnoticed and without consequences for the diagnostic routine schedule in primary or metastatic malignant diseases of the locomotor system. However, the general opinion that ultrasound analysis of skeletal lesions is impossible due to the high attenuation of ultrasound by the bone matrix ignores the fact that tumorous changes may concern not only the cortical layer and spongiosa (visible in conventional X-ray) but also the periosteum and surrounding tissue. Based on data from a large number of patients, we seek to demonstrate that such reservations toward ultrasound in the evaluation of bone metastases are not justified.