Sinan SÖZÜTOK, Serdar TARHAN, Fatih DÜZGÜN, Elvan S.BİLGİN

Kemik metastazlarının saptanmasında kemik sintigrafisi ve tüm vücut difüzyon manyetik rezonans görüntülemenin karşılaştırılması

Amaç: Bu çalışmanın amacı malignitelerde yaygın olarak görülen kemik metastazının saptanmasında yeni bir yöntem olarak tüm vücut difüzyon ağırlıklı manyetik rezonans görüntülemenin (TVDAMRG) etkinliğini ve başarısını kemik sintigrafisi ile karşılaştırarak değerlendirmektir. Gereç ve Yöntem: Primer malignitesi ve kemik metastazları olan toplam 21 hastanın tüm vücut difüzyon MRG (manyetik rezonans görüntüleme) bulguları retrospektif olarak değerlendirilmiş ve bulgular kemik sintigrafisi ile karşılaştırılmıştır. Bulgular: 21 hastada kemik sintigrafisiyle saptanan toplam 143 metastatik lezyon mevcuttur. Saptanan 143 kemik metastazından 96 tanesi difüzyon MRG’de de tespit edilebilmiştir. Difüzyon MRG’nin tespit başarısının en yüksek olduğu bölge alt ekstremiteler olmuştur ve 13 metastazın 12’sini %92.3’lük oranla tespit edebilmiştir. Vertebralar diğer başarılı olunan bölge olup 45 metastazın 39’u difüzyon MRG’de de izlenebilmiştir. Başarı yüzdesi %86.6 dır. Üst ekstremite, pelvis ve kranial bölgelerdeki saptama oranı sırasıyla %73.6, %63.1 ve %60 olarak hesaplanmıştır. En başarısız bölge ise kostalar olmuştur. Kostalarda mevcut olan 42 metastazın sadece 16’sı tespit edilebilmiş olup saptama yüzdesi %38.1’dir. Sonuç: Çalışmamızda elde ettiğimiz bulgular doğrultusunda tüm vücut difüzyon MR görüntülemenin kemik metastazlarının tespitinde özellikle aksiyal iskelette başarılı olabileceği düşünülmüştür. Kostalardaki başarısızlık oranı yeni geliştirilecek manyetik duyarlılık teknolojileri, artırılan geometrik rezolüsyon ve hareket artefaktını engelleyecek hızlı sekanslar sayesinde düzeltilebilir.

Comparison of bone scintigraphy and whole-body diffusion-weighted magnetic resonance imaging in the detection of bone metastases

Purpose: The aim of this study was o evaluate the efficacy and success of whole-body diffusion-weighted magnetic resonance imaging (WB-DW-MRI) as a new method for the detection of bone metastasis commonly seen in malignancies, compared to bone scintigraphy. Materials and Methods: The WB-DW-MRI findings of 21 patients with primary malignancies and bone metastases were retrospectively evaluated and compared to scintigraphy findings. Results: Twenty-one patients had 143 metastatic lesions detected by scintigraphy, and 96 of these bone metastases were also detected on WB-DW-MRI. The area where the success of WB-DW-MRI was highest was the lower extremities, for which 12 (92.3%) of 13 metastases were identified. This was followed by vertebrae, for which WB-DW-MRI detected 39 (86.6%) of 45 metastases. The metastasis detection rates for the upper extremities, pelvis, and cranium were calculated as 73.6%, 63.1%, and 60%, respectively. WB-DW-MRI was least successful in identifying metastases in ribs, with only 16 (38.1%) of 42 metastases being detected by this modality. Conclusion: In line with the findings obtained from this study, it is considered that WB-DW-MRI may be successful in the detection of bone metastases, especially in the axial skeleton. The failure observed for the ribs can be remedied by newly developed magnetic sensitivity technologies, increasing geometric resolution, and fast sequences that will prevent motion artifacts.

Keywords:

BONE METASTASES, whole-body diffusion MRI, bone scintigraphy,

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