Magnetic resonance imaging to detect bone marrow metastases in the initial staging of small cell lung carcinoma and breast carcinoma

Layer, G.; Steudel, A.; Schüller, Heinrich; Kaick, G. van; Grünwald, Frank; Reiser, Maximilian; Schild, Hans H.

doi:10.1002/(sici)1097-0142(19990215)85:4<1004::aid-cncr31>3.0.co;2-2

Cited by 36 publications

(2 citation statements)

References 29 publications

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“…In recent years, several studies demonstrated that 18-FDG-PET might improve and simplify staging, with a superior detection rate of bone metastases than bone scintigraphy. MRI and PET reveal bone or bone marrow replacement in up to 70% of patients with SCLC at initial presentation, whereas bone scintigraphy misses 30-60% of cases and CT probably even more [5,18,19]. A more extended use of 18-FDG-PET for baseline staging would likely lead to a greater finding of bone involvement at diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Osteoblastic Flare During Chemo-Immunotherapy in Small Cell Lung Cancer: Do Not Be Misleaded!

2023

Ann Case Report

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Introduction: "Osteoblastic flare" is defined as a temporary increase in bone tracer uptake associated with therapy response in patients without previously detected bone metastases. Hypothetically these apparently "new osteoblastic" lesions are not visible at baseline and are radiologically detected only after a bone sclerotic healing reaction has appeared, for this reason it does not indicate disease progression, but the healing of previously inconspicuous lesions. This phenomenon has been described in several solid tumours as response to antineoplastic treatments; however, it had never been reported in patients with ES-SCLC treated with chemo-immunotherapy. Methods:The Computed Tomography scans (CTs) of five patients with ES-SCLC treated with first-line chemo-immunotherapy with Atezolizumab, Carboplatin and Etoposide, were retrospectively reviewed to analyse the bone response to treatment compared with the response of the visceral tumour.Results: On reassessment CTs the development of new onset osteoblastic lesions was associated with a partial response in the other disease sites. In each case, osteoblastic lesions, developed during therapy, were considered as a response reflecting bone repair and efficacy of the treatment. Therefore, the maintenance therapy was continued obtaining a temporary stability of the disease. In view of the increasing use of chemo-immunotherapy in this setting, it is important not to confuse this phenomenon with disease progression, in order to avoid discontinuation of the maintenance immuno-therapy treatment, which the patient could benefit from.

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Section: Discussionmentioning

confidence: 99%

Osteoblastic Flare During Chemo-Immunotherapy in Small Cell Lung Cancer: Do Not Be Misleaded!

2023

Ann Case Report

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“…MRI has been acknowledged to depict marrow infiltration before scintigraphic-detectable structural or metabolic abnormalities can be identified. 11,42,54,62,63 Lesions that produce asymptomatic marrow metastases are frequently not evident on scintigraphy, but they have been proven to be identified on MRI. 64 Several studies have directly compared various 1.5-T WBMRI techniques to 99m Tc-MDP planar skeletal scintigraphy either in direct assessment of skeletal metastatic disease or as part of generalized TNM staging.…”

Section: Comparison Of Whole-body Magnetic Resonance Imaging To Altermentioning

confidence: 99%

Whole-Body Magnetic Resonance Imaging: Assessment of Skeletal Metastases

Moynagh¹,

Colleran²,

Tavernaraki³

et al. 2010

Semin Musculoskelet Radiol

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Whole-Body Dual-Modality PET/CT and Whole-Body MRI for Tumor Staging in Oncology

Antoch¹

2003

JAMA

514

310

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Context Deciding on the appropriate therapy for patients with malignant diseases mandates accurate tumor staging with whole-body coverage. Magnetic resonance imaging (MRI) and a combined modality including positron emission tomography (PET) and computed tomography (CT) provide whole-body tumor staging in a single session.Objective To determine the staging accuracies of both whole-body PET/CT and wholebody MRI for different malignant diseases. Design, Setting, and Patients Prospective, blinded, investigator-initiated study of 98 patients (mean age, 58 years; range, 27-94 years) with various oncological diseases who underwent back-to-back whole-body glucose analog [18F]fluorodeoxyglucose-PET/CT and whole-body MRI for tumor staging. The study was conducted at a university hospital from December 2001 through October 2002 and had a mean follow-up of 273 days (range, 75-515 days). The images were evaluated by 2 different, blinded reader teams. The diagnostic accuracies of the 2 imaging procedures were compared. Main Outcome Measures Correct classification of the primary tumor, regional lymph nodes, and distant metastasis (overall TNM stage) using whole-body PET/CT and wholebody MRI. Secondary outcome measures were accurate assessment of T-stage, Nstage, and M-stage by the 2 imaging procedures. ResultsOf 98 patients, the overall TNM stage was correctly determined in 75 with PET/CT (77%; 95% confidence interval [CI], 67%-85%) and in 53 with MRI (54%; 95% CI, 44%-64%) (PϽ.001). Compared with MRI, PET/CT had a direct impact on patient management in 12 patients. Results from MRI changed the therapy regimen in 2 patients compared with PET/CT. Separate assessment of T-stage (with pathological verification) in 46 patients revealed PET/CT to be accurate in 37 (80%; 95% CI, 66%-91%) and MRI to be accurate in 24 (52%; 95% CI, 37%-67%) (PϽ.001). Of 98 patients, N-stage was correctly determined in 91 patients with PET/CT (93%; 95% CI, 86%-97%) and in 77 patients with MRI (79%; 95% CI, 69%-86%) (P=.001). Both imaging procedures showed a similar performance in detecting distant metastases. ConclusionsThe feasibility and diagnostic accuracy of the whole-body staging strategies of PET/CT and MRI are established. Superior performance in overall TNM staging suggests the use of [18F]-fluorodeoxyglucose-PET/CT as a possible first-line modality for whole-body tumor staging.

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Magnetic resonance imaging to detect bone marrow metastases in the initial staging of small cell lung carcinoma and breast carcinoma

Cited by 36 publications

References 29 publications

Osteoblastic Flare During Chemo-Immunotherapy in Small Cell Lung Cancer: Do Not Be Misleaded!

Osteoblastic Flare During Chemo-Immunotherapy in Small Cell Lung Cancer: Do Not Be Misleaded!

Whole-Body Magnetic Resonance Imaging: Assessment of Skeletal Metastases

Whole-Body Dual-Modality PET/CT and Whole-Body MRI for Tumor Staging in Oncology

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