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Review
. 2018 Jul 9;8(3):45.
doi: 10.3390/diagnostics8030045.

Whole-Body MRI with Diffusion-Weighted Imaging in Bone Metastases: A Narrative Review

Alessandro Stecco  1 , Alessandra Trisoglio  2 , Eleonora Soligo  3 , Sara Berardo  4 , Lidiia Sukhovei  5 , Alessandro Carriero  6
Affiliations
Review

Whole-Body MRI with Diffusion-Weighted Imaging in Bone Metastases: A Narrative Review

Alessandro Stecco et al. Diagnostics (Basel). .

Abstract

Whole body magnetic resonance imaging (MRI) with diffusion-weighted imaging (WB-MRI-DWI) is currently emerging as a diagnostic technique in the evaluation of bone metastases from breast, prostate, lung, thyroid, and melanoma tumors. The most relevant articles regarding the detection of solid tumor bone metastases with MRI have been reviewed and cited. The imaging methods currently used in the detection of bone metastases are bone scintigraphy, computed tomography (CT), and positron emission tomography (PET/CT) with 2-deoxy-2-[fluorine-18] fluoro-d-glucose (18F-FDG PET/CT). WB-MRI-DWI allows qualitative and quantitative evaluation of focal lesions through signal intensity evaluation on DWI images and the reconstruction of the apparent diffusion coefficient (ADC) map. In prostate and breast cancer, WB-MRI-DWI is useful in assessing the response of bone lesions to therapy and to detecting early non-responders, while in lung cancer the method shows a similar sensitivity to 18F-FDG PET/CT in the detection of bone metastases. In bone metastases of thyroid tumors and melanoma, the WB-MRI-DWI shows a higher sensitivity when compared to 18F-FDG PET/CT. With a standardization of the WB-MRI-DWI protocol, this method seems to play an important role in the diagnosis of bone solid tumor metastases.

Keywords: bone metastasis; breast cancer; diffusion-weighted imaging; lung cancer; melanoma; thyroid cancer; whole-body magnetic resonance imaging.

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Conflict of interest statement

The authors declare no conflict of interest

Figures

Figure 1
Figure 1
(A) Diffusion-weighted imaging (DWI) sequence in sagittal plane shows focal alteration of diffusivity. (B) The sagittal plane of TSE T1 shows, in the same level, a hypointense region of the dorsal soma related to the secondary localization of prostate cancer.
Figure 2
Figure 2
Bone localizations of breast cancer in the coronal plane: scapula and vertebral metastases (in the red circles). (A) DWI with a “positron emission tomography (PET)-like” view. The right scapula and one lumbar vertebra present an alteration of diffusivity. (B) T1 DIXON showing the hypointensity of the scapula and (C) lumbar soma.
Figure 3
Figure 3
(A) This chest X-ray reveals, in the red circle, a lung tumor which is also visible in (B) whole body magnetic resonance imaging with diffusion-weighted imaging (WB-MRI-DWI) in the coronal plane, in the red circle.
Figure 4
Figure 4
Focus on the red circles: (A) DIXON T2 weighted in the sagittal plane showing bone cervical metastasis (C5) (B) a low apparent diffusion coefficient (ADC) value in the same level, and (C) a restriction of diffusivity.
Figure 5
Figure 5
(A) A T1 sequence and (B) STIR sequence, performed with a dedicated spinal MRI, highlight the lung metastases. (C) Cervical spine on a sagittal reconstruction of a computed tomography (CT). The bone metastasis is not so clear.
See this image and copyright information in PMC

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