[Magnetic resonance tomography of the bone marrow for the detection of metastases of solid tumors]

Abstract

The bone marrow is a common site of metastases in patients with solid tumors. Metastatic bone marrow involvement is found much more frequently at autopsy than in routine staging procedures. The purpose of this study was to evaluate the diagnostic efficacy of bone marrow MRI in such patients, and especially in those with small cell lung cancer and female breast carcinoma. MRI is a fast and reliable method for the early detection of bone marrow metastases in patients with carcinoma. In many studies and according to our own experience, it is much more sensitive than radionuclide bone scan, iliac crest biopsy and plain film radiography. However, a clear clinical benefit of its use in the initial staging has so far been proven only for patients with small cell lung cancer. As a consequence, MRI should be applied for the staging of solid tumors only when clinical examination does not yield unambiguous results. Owing to its superiority to biopsy and bone scan, bone marrow MRI should become an integral part of the initial staging procedure in small cell lung cancer and wherever it is sufficiently available it can replace the conventional diagnostic procedures.