ANALYSIS OF THE DIAGNOSTIC VALUE OF MAGNETIC RESONANCE COMPUTER TOMOGRAPHY AND POSITRON EMISSION COMPUTER TOMOGRAPHY WITH 18F-FDG IN IDENTIFICATION OF SPINAL AND PELVIC BONE METASTASES

Background. The treatment outcomes for non-small cell lung cancer (NSCLC) depend on the tumor stage and treatment strategy. The imaging techniques play a significant role in the diagnosis, staging and choice of appropriate treatment for NSCLC.

Purpose of the study: сomparison of the diagnostic capabilities of magnetic resonance imaging (MR) and positron emission computed tomography to select the optimal approaches to early detection of spinal and pelvic bone metastases.

Material and Methods. The treatment outcomes were analyzed in 71 patients with NSCLC. Spinal and pelvic bone metastases were detected in 24 patients using magnetic resonance imaging (MRI) and positron emission computed tomography (PET/CT). Multiple bone lesions were the most common. A total of 69 metastatic lesions were identified. To compare the capabilities of diagnostic techniques, all patients underwent PET/CT with ¹⁸F-FDG, and MRI of the spine and pelvic bones using diffused-weighted images (DWI). Statistical data processing included the calculation of the sensitivity, specificity and diagnostic accuracy of the above techniques.

Conclusion. The comparative analysis of the capabilities of modern high-tech diagnostic techniques (PET/CT with ¹⁸F-FDG and MRI of the spine and pelvic bones with DWI) in early detection of bone metastases in patients with NSCLC, PET/CT with ¹⁸F-FDG showed the greatest diagnostic value. However, taking into account the high sensitivity and specificity of MRI with DVI in detection of bone metastases and limited availability of PET/CT for patients, MRI with DVI is recommended to exclude bone metastases. 

1. Davydov M.I., Polotskii B.E. Lung cancer. Moscow, 2003. 454 p. (in Russian).

2. Kaprin A.D., Starinskij V.V., Shaxzadova A.O. The state of cancer care for the population of Russia in 2019. Moscow, 2020. 239 p. (in Russian).

3. Ejima Y., Matsuo Y., Sasaki R. The current status and future of radiotherapy for spinal bone metastases. J Orthop Sci. 2015 Jul; 20(4): 585–92. doi: 10.1007/s00776-015-0720-x.

4. Laryukov A.V., Laryukova E.K. Distant metastasis features of peripheral nonsmall cell lung cancer. Practical Medicine. 2012; 7(62): 163–165. (in Russian).

5. Machado Medeiros T., Altmayer S., Watte G., Zanon M., Basso Dias A., Henz Concatto N., Hoefel Paes J., Mattiello R., de Souza Santos F., Mohammed T.L., Verma N., Hochhegger B. 18F-FDG PET/CT and whole-body MRI diagnostic performance in M staging for non-small cell lung cancer: a systematic review and meta-analysis. Eur Radiol. 2020 Jul; 30(7): 3641–3649. doi: 10.1007/s00330-020-06703-1.

6. Ohno Y., Takeshi Y., Takenaka D., Koyama H., Aoyagi K., Yui M. Comparison of Diagnostic Accuracy for TNM Stage Among Whole-Body MRI and Coregistered PET/MRI Using 1.5-T and 3-T MRI Systems and Integrated PET/CT for Non-Small Cell Lung Cancer. Am J Roentgenol. 2020 Nov; 215(5): 1191–1198. doi: 10.2214/AJR.19.22565.

7. Krzhivitskii P.I.,Kanaev S.V., Semenov I.I., Novikov S.N.Radiology and nuclear methods in detection of bone metastases. Radiation Oncology and Nuclear Medicine. 2012; 2: 72–77. (in Russian).

8. Sergeev N.I., Nudnov N.V. Differential diagnosis of benign and malignant lesions of the spine according to magnetic resonance imaging with the use of bolus contrast enhancement. Bulletin of the Russian Scientific Center for Roentgenoradiology. 2012; 2(3): 30–35. (in Russian).

9. Dickinson F., Liddicoat A., Dhingsa R., Finlay D. Magnetic resonance imaging versus radionuclide scintigraphy for screening in bone metastases. Clin Radiol. 2000 Aug; 55(8): 653. doi: 10.1053/crad.2000.0418.

10. Berquist T.H. MRI of the musculoskeletal system. Lippincott Williams & Wilkins, 2006. 204 p.

11. Li C., Liu Z.S., Du X.M., He L., Chen J., Wang W., Sun F., Du F., Luo Z.G., Xue Z.L., Zhao Y., Zhou C.W. Clinical value of whole-body magnetic resonance diffusion weighted imaging on detection of malignant metastases. Chin Med Sci J. 2009 Jun; 24(2): 112–6. doi: 10.1016/s1001-9294(09)60072-9.

12. Sergeev N.I., Kotlyarov P.M., Solodkii V.A., Ovchinnikov V.I. Magnetic-resonance tomography in an estimation of efficiency of chemotherapy and radiotherapy at metastasis disease of a spine and bone pelvis. Medical vizualization. 2013; 1: 109–114. (in Russian).