Imaging

Metastatic lesions to bone

Preliminary Diagnosis: Metastatic lesions to bone

I. What imaging technique is first-line for this diagnosis

  • The first-line imaging modality is plain radiography.

II. Describe the advantages and disadvantages of this technique for diagnosis of metastatic lesions to bone.

  • Plain radiography is a highly portable imaging modality.

  • Plain radiography exposes patients to minimal ionizing radiation.

  • Plain radiography offers exquisite visualization of the surrounding osseous structures.

  • Plain radiography is moderately sensitive and specific in detailing any suspicious sclerotic and lytic osseous lesions.

  • Plain radiography is limited in detailing the surrounding soft tissues, osseous structures, and vasculature.

III. What are the contraindications for the first-line imaging technique?

  • No specific contraindications to plain radiography exist.

IV. What alternative imaging techniques are available?

  • Alternative imaging techniques include CT imaging without contrast of the area of concern and nuclear medicine technetium 99 m MDP whole body scintigraphic imaging.

V. Describe the advantages and disadvantages of the alternative techniques for diagnosis of metastatic lesions to bone.

CT

Advantages

  • Highly sensitive and specific in detailing any suspicious abnormal areas of increased sclerosis and lucency for osseous metastatic foci

  • Better characterizes the surrounding soft tissues, vasculature, and osseous structures

  • May help guide percutaneous biopsy

Disadvantages

  • Exposes patients to ionizing radiation

  • Less portable than plain radiography

Nuclear Medicine

Advantages

  • Highly sensitive and moderately to highly specific in detecting osseous metastatic lesions

Disadvantages

  • Less adept in detailing the surrounding soft tissues, osseous structures, and vasculature

  • Exposes patients to ionizing radiation

  • May be subject to artifact from technical imaging complications

  • False positives may be noted in patients with an underlying infection or inflammatory process

VI. What are the contraindications for the alternative imaging techniques?

  • CT imaging may be contraindicated in pregnant patients

  • Nuclear medicine Technetium 99 m MDP imaging may be contraindicated in pregnant patients and patients breastfeeding

You must be a registered member of ONA to post a comment.

Sign Up for Free e-newsletters

Regimen and Drug Listings

GET FULL LISTINGS OF TREATMENT Regimens and Drug INFORMATION

Bone Cancer Regimens Drugs
Brain Cancer Regimens Drugs
Breast Cancer Regimens Drugs
Endocrine Cancer Regimens Drugs
Gastrointestinal Cancer Regimens Drugs
Genitourinary Cancer Regimens Drugs
Gynecologic Cancer Regimens Drugs
Head and Neck Cancer Regimens Drugs
Hematologic Cancer Regimens Drugs
Lung Cancer Regimens Drugs
Other Cancers Regimens
Rare Cancers Regimens
Skin Cancer Regimens Drugs