CT of Metastases

Structural changes induced by antineoplastic therapies: keys to evaluate tumor response to treatment

“…In such cases the usual osteoblastic process takes place with synthesis of young osteoid tissue and apparently preserved osteonal architecture. The mineral component is, however, preponderant, with a marked reduction of the trabecular spaces and therefore a compact, ivory appearance [13]. This is the typical evolution of lytic metastases to the bone (as in breast carcinoma; Fig.…”

“…2). This appearance often correlates with a reduction of appropriate tumor markers (carcino-embryonic antigen, carcinogenetic antigen 125, carcinogenetic antigen 19.9, prostate-specific antigen) [13].…”

“…This is the typical evolution of lytic metastases to the bone (as in breast carcinoma; Fig. 1) or of myelomatous lesions after chemotherapy and/or radiation, where a marked increase of mineral deposition takes place [13].…”

“…The process of calcification, on the other hand, consists of deposition of calcium salts in insoluble forms in extraskeletal organs and tissues [13]. Its pathogenesis is complex and not entirely clarified in its details, but is probably related to the local environmental factors.…”

“…There are two different phenomena recognized, markedly different from both the pathogenesis and the histological appearance: ossification and calcification [13].…”