Oncologic imaging: Interactions of nuclear medicine with CT and MRI using the bone scan as a model

https://doi.org/10.1016/S0001-2998(97)80044-XGet rights and content

There are many radionuclides currently used in oncologic imaging including technetium 99m diphosphonates, gallium 67, thallium 201, technetium 99m sestamibi, and others. The specific interactions of each of these agents with computed tomography (CT) and magnetic resonance imaging (MRI) are extensive. The radionuclide bone scan using 99mTc diphosphonate is the most frequently performed nuclear medicine examination in oncologic imaging. The bone scan can be used as a model to generalize the interactions of nuclear medicine with CT and MRI. The applications for the bone scan and many other nuclear medicine procedures in oncologic imaging include evaluating for metastases, assessing the response to therapy, and guiding radiation therapy planning. Bone scan findings that are equivolcal for metastases can be evaluated with other imaging modalities. Areas of abnormal uptake in the axial skeleton can be evaluated with CT or MRI, whereas those in the appendicular skeleton can be evaluated with plain radiographs, followed by CT or MRI if necessary. The bone scan is valuable in oncologic imaging because of its high sensitivity for lesion detection, its ease in whole body imaging, and its low cost. The major disadvantage of the bone scan is that it lacks fine anatomic detail, which is of particular importance in the cancer patient with local back pain, radiculopathy, or myelopathy. Because local back pain with or without radiculopathy is the earliest symptom of spinal cord compression in 90% of patients, an MRI is the study of choice because of its exquisite depiction of anatomy. A myelogram followed by a postmyelogram CT can be performed if there are contraindications to an MRI. The basic principle of high sensitivity for lesion detection and ease in whole body imaging provided by nuclear medicine and fine anatomic detail provided by CT and MRI can be applied also to the use of other radionuclides in oncologic imaging.

References (39)

  • HounsfieldGN

    Computerized transverse axial scanning (tomography): Part I. Description of system

    Br J Radiol

    (1973)
  • BakerHL

    Historical vignette: Introduction of computed tomography in North America

    AJNR

    (1993)
  • ShellockFG et al.

    MR Procedures and biomedical implants material, and devices: 1993 update

    Radiology

    (1993)
  • SubramanianG et al.

    A new complex of Tc-99m for skeletal imaging

    Radiology

    (1971)
  • BlauM et al.

    Fluorine-18: A new isotope for bone scanning

    J Nucl Med

    (1962)
  • CharkesND et al.

    Early Diagnosis of Metastatic Bone Cancer by Photoscanning with Strontium-85

    J Nucl Med

    (1964)
  • CharkesND et al.

    Detection of metastatic cancer bone by scintiscanning with 87m-Sr

    AJR

    (1964)
  • MichelF et al.

    Initial staging of non-small cell lung cancer: Value of routine radioisotope bone scanning

    Thorax

    (1991)
  • SilvestriGA et al.

    The clinical evaluation for detecting metastatic lung cancer: A meta-analysis

    Am J Respir Crit Care Med

    (1995)
  • Cited by (0)

    View full text