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Comparative Study
. 2009 Mar;69(3):567-73.
doi: 10.1016/j.ejrad.2007.11.039. Epub 2008 Jan 11.

Detection of osseous metastases of the spine: comparison of high resolution multi-detector-CT with MRI

Sonja Buhmann Kirchhoff  1 , Christoph Becker, Hans Roland Duerr, Maximilian Reiser, Andrea Baur-Melnyk
Affiliations
Comparative Study

Detection of osseous metastases of the spine: comparison of high resolution multi-detector-CT with MRI

Sonja Buhmann Kirchhoff et al. Eur J Radiol. 2009 Mar.

Abstract

Purpose: The aim of the study was to evaluate the diagnostic accuracy of multi-slice-computed tomography (MDCT) for the detection of vertebral metastases in comparison to magnetic resonance imaging (MRI).

Materials and methods: In a retrospective analysis, 639 vertebral bodies of 41 patients with various histologically confirmed primary malignancies were analysed. The MDCT-images were acquired on a 16/64-row-MDCT scanner (Siemens Somatom Sensation 16/64). MRI was performed on 1.5 T scanners (SIEMENS Symphony/Sonata). The MDCT- and MRI-images were evaluated separately by two experienced radiologists in a consensus reading. The combination of MDCT and MRI in an expert reading including follow-up examinations and/or histology as well as clinical data served as the gold standard.

Results: 201/639 vertebral bodies were defined as metastatically affected by the gold standard. In MDCT 133/201 lesions, in MRI 198/201 lesions were detected. 68 vertebral bodies were false negative in MDCT, whereas 3 false negatives were found in MRI. 3 false positive results were obtained in MDCT, 5 in MRI. Sensitivity was significantly lower for MDCT (66.2%) than for MRI (98.5%) (p<0.0001). Specificity was not significantly different for both methods (MDCT: 99.3%; MRI: 98.9%). The diagnostic accuracy resulted in 88.8% for MDCT and 98.7% for MRI.

Conclusion: Although 16/64-row-MDCT provides excellent image quality and a high spatial resolution in the assessment of bony structures, metastatic lesions without significant bone destruction may be missed. The diagnostic accuracy of MRI proved to be significantly superior to 16/64-row-MDCT for the detection of osseous metastases.

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