Abstract
Bone metastases are very common complications associated with certain types of cancers that frequently negatively impact the quality of life and functional status of patients; thus, early detection is necessary for the implementation of immediate therapeutic measures to reduce the risk of skeletal complications and improve survival and quality of life. There is no consensus or universal standard approach for the detection of bone metastases in cancer patients based on imaging. Endorsed by the Spanish Society of Medical Oncology (SEOM), the Spanish Society of Medical Radiology (SERAM), and the Spanish Society of Nuclear Medicine and Molecular Imaging (SEMNIM) a group of experts met to discuss and provide an up-to-date review of our current understanding of the biological mechanisms through which tumors spread to the bone and describe the imaging methods available to diagnose bone metastasis and monitor their response to oncological treatment, focusing on patients with breast and prostate cancer. According to current available data, the use of next-generation imaging techniques, including whole-body diffusion-weighted MRI, PET/CT, and PET/MRI with novel radiopharmaceuticals, is recommended instead of the classical combination of CT and bone scan in detection, staging and response assessment of bone metastases from prostate and breast cancer.Clinical trial registration: Not applicable.
Highlights
Introductionmagnetic resonance imaging (MRI) is the technique of choice to detect complications of metastasis, such as pathological fractures or spinal cord compression in the case of vertebral lesions, allowing an accurate evaluation of the extension to adjacent structures and the possible infiltration of soft tissues or neurovascular bundles
Computed tomography (CT) computed tomography, 18FDG-PET/CT 18-fluorodeoxyglucose-positron emission tomography/computed tomography a High-risk patients are considered those with inoperable locally advanced breast cancer, inflammatory cancer, breast cancer diagnosed during pregnancy, cancer with more than four positive nodes, or triple-negative breast cancer destruction without reparative osteoblastic activity, but this response is uncommon
Certain limitations of scintigraphic images could be partially solved when evaluating the response to treatment by applying the most recent technological advances, such as the quantification of tumor load, quantitative normalization of the uptake intensity and segmentation of bone uptake compared to healthy controls [89]
Summary
MRI is the technique of choice to detect complications of metastasis, such as pathological fractures or spinal cord compression in the case of vertebral lesions, allowing an accurate evaluation of the extension to adjacent structures and the possible infiltration of soft tissues or neurovascular bundles It is an excellent technique for the early detection of bone marrow infiltration, which precedes the morphological changes produced by bone metastases and, for the early detection of metastatic bone disease [38]. The SKELETA prospective clinical trial evaluated patients with breast cancer and with prostate cancer (PCa) with a high risk of metastatic bone disease using bone scintigraphy, single photon emission computed tomography (SPECT), SPECT/CT, 18F-sodium-fluoride (18F-NaF)PET/CT and diffusion-weighted WB-MRI. The weaknesses of NaF-PET are similar to those of bone scanning and are mainly based on the high increase in bone remodeling in certain benign lesions and posttraumatic and infectious lesions
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
