Abstract
MR imaging is the primary tool for evaluation and monitoring of spinal tumors. We retrospectively analyzed the MR imaging findings before and after SRS for metastatic spinal tumors. We reviewed MR imaging findings on 79 metastatic spinal tumor lesions in 44 patients (29 male and 15 female)who had undergone radiosurgery between November 2003 and April 2008. Posttreatment MR imaging was evaluated retrospectively for 3 aspects: 1) changes in tumor volume; 2) changes in T2 signal intensity;and 3) changes in contrast enhancement patterns. With regard to tumor volume on MR images, 32 lesions(40.5%) decreased in volume (group 1), 39 (49.4%) showed no change (group 2), and 8 (10.1%) increased in volume (group 3). T2 signal intensities were unchanged in 4 lesions (type 1), homogeneously increased in 3 (type 2), and changed to a homogeneously dark signal in 4 (type 4). The T2 signal intensity was increased and inter mixed with dark signal intensity (type 3) in 68 lesions. A decrease in contrast enhancement with or without non-enhancing foci was seen in 73 lesions. A persistent homogeneous enhancement pattern was seen in all 4 of the type 1 lesions, in 1 of the 3 type 2 lesions, and in 1 of the 68 type 3 lesions. Main MR imaging features of locally controlled metastatic spinal tumors included no increase in tumor volume, increased T2 signal intensity with intermixed T2 dark signal intensity,and decreased contrast enhancement. Follow-up MR imaging also provided several patterns of tumor recurrence [corrected].
Highlights
MethodsAmong 113 spinal metastatic lesions in 72 patients, 10 lesions were osteoblastic
AND PURPOSE: We reported the MR findings of spinal metastatic lesions after SRS according to the volumetric changes
In group 1, the most common findings were increased T2 signal intensity intermixed with dark signal intensity, and 28 (87.5%) of the total 32 lesions were seen with this pattern (Fig 2)
Summary
Among 113 spinal metastatic lesions in 72 patients, 10 lesions were osteoblastic. CT and MR images were reviewed to identify 4 parameters: 1) changes in tumor volume, 2) changes in CT attenuation, 3) changes in T2 signal intensities and 4) changes in degrees of contrast enhancement. Patients This retrospective study was approved by the institutional review board of our hospital and patient informed consent was waived. Diagnosis of spinal metastasis was established by typical MR and CT imaging findings, such as paravertebral soft tissue mass, osteolytic or osteoblastic changes, and involvement of posterior elements. Primary tumor pathology was consistent with hepatocellular carcinoma (n ϭ 12), lung cancer (n ϭ 11), breast cancer (n ϭ 4), prostate cancer (n ϭ 3), renal cell cancer (n ϭ 3), colon cancer (n ϭ 2), nasopharyngeal cancer (n ϭ 2), thyroid cancer (n ϭ 2), ureter cancer (n ϭ 1), parotid cancer (n ϭ 1), malignant thymoma (n ϭ 1), soft tissue sarcoma (n ϭ 1), and squamous cell carcinoma from unknown origin (n ϭ 1)
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