CAPABILITIES OF MAGNETIC RESONANCE IMAGING IN THE DETECTION OF METASTATIC LESION OF THE SPINE AND PELVIC BONES IN PATIENTS WITH PERIPHERAL NON-SMALL CELL LUNG CANCER

Objective. To comparatively analyze the diagnostic capabilities of magnetic resonance imaging (MRI) of the spine and pelvic bones with the results of 18F-FDG positron emission computed tomography (PET/CT) and single-photon emission computed tomography (SPECT/CT) in the detection of skeletal metastases in patients with peripheral non-small cell lung cancer (PNSCLC) in order to elaborate optimal approaches to using radiation and nuclear diagnostic techniques.

Material and methods. Seventy-one patients with PNSCLC underwent a comprehensive examination of the skeleton regardless of whether they had clinical symptoms of bone lesions. MRI of the spine and pelvic bones, 18F-FDG PET/CT, and SPECT/CT were performed in all the patients with PNSCLC. The investigators analyzed MRI changes in different skeletal parts (cervical, thoracic, lumbar spine, sacrum and pelvic bones) in patients with PNSCLC and compared the findings with the results of a set of radiation and nuclear diagnostic techniques (18F-FDG PET/CT, SPECT/CT). The sensitivity, specificity and diagnostic accuracy of imaging techniques were compared. Clinical cases are presented.

Results. 18F-FDG PET/CT is superior to MRI for the detection of metastatic lesions of the spine and pelvic bones. The sensitivity, specificity, and diagnostic accuracy of MRI for the identification of metastases in the spine and pelvic bones were 95.65, 96.8, and 95.85%, respectively. Those of 18F-FDG PET/CT in the detection of bone metastases were 98.7, 99.9, and 99.6%, respectively.

Conclusion. 18F-FDG PET/CT is indicated for all patients with PNSCLC to rule out skeletal metastases. It is expedient to perform MRI if there are technical problems with 18F-FDG PET/CT for the detection of metastatic lesion of the spine and pelvic bones. 

1. Spiro S. Carcinoma of the lung. European respiratory Monograph. Sheffield. UK; 1995.

2. Крживицкий П.И., Канаев С.В., Семенов И.И., Новиков С.Н. Лучевые и ядерные методы диагностики метастатического поражения скелета. Радиационная онкология и ядерная медицина. 2012; 2: 72–7. [Krzhivitskiy P.I., KanaevS.V., Semenov I.I., Novikov S.N. Imaging modalities for diagnosis of bone metastases. Radiation Oncology and Nuclear Medicine. 2012; 2: 72–7 (in Russ.).]

3. Трахтенберг А.Х., Франк Г.А., Поддубный В.В. Особенности диагностики и лечения крупноклеточного рака легкого. Российский онкологический журнал. 2007; 3: 4–8. [Trakhtenberg A.Kh., FrankG.A., Poddubnyy V.V. Features of diagnosis and treatment of large-cell lung cancer. Russian Journal of Oncology. 2007; 3: 4–8 (in Russ.).]

4. Веснин А.Г., Семенов И.И. Атлас лучевой диагностики опухолей опорно-двигательного аппарата. СПб; 2002. [Vesnin A.G., SemenovI.I. Atlas of radiation diagnosis of tumors of the musculoskeletal system. St. Petersburg; 2002 (in Russ.).]

5. Ларюков А.В., Ларюкова Е.К. Современные возможности методов лучевой и ядерной диагностики в выявлении костных метастазов периферического немелкоклеточного рака легкого. Практическая медицина.2016; 1 (93): 112–9. [Laryukov A.V., Laryukova E.K. Modern possibilities of radiology and nuclear methods in diagnosis of bone metastases of peripheral nonsmall cell lung cancer. Practical Medicine. 2016; 1 (93): 112–9 (inRuss.).]

6. Сергеев Н.И., Нуднов Н.В. Дифференциальная диагностика доброкачественных и злокачественных поражений позвоночника по данным магнитно-резонансной томографии с использованием болюсного контрастного усиления. Вестник Российского научного центра рентгенорадиологии Минздрава России. 2012; 2 (3): 30–5. [Sergeev N.I., Nudnov N.V. Differential diagnosis of benign and malignant lesions of the spine on magnetic resonance imaging using a dynamic contrast enhancement. Vestnik of the Russian Scientific Center of Roentgenoradiology of the Ministry of Healthcare of the Russian Federation. 2012; 2 (3): 30–5 (in Russ.).]

7. Heliar V., Mohan H., Barwick T., Livieratos L., Cnanasegaren G., Clarke S.E. et al. The added value of multislice SPECT/CT in patients with equivocal bone metastases from carcinoma of the prostate. Eur. J. Nucl. Med. Mol. Imaging. 2010; 37 (4): 706–13.

8. Lu S., Wang D., Li Y. Whole body MRI for detecting osseous metastases. Clin. J. Radiol. 2014; 65: 459–62.

9. Pearce T., Philips S., Brown J., KohD.M., Bum P.R. Bone metastases from prostate, breast, and multiple myeloma: differences in lesion conspicuity at short-tau inversionrecovery and diffusionweighted MRI. Br. J. Radiol. 2012; 85 (1016): 1102–6.

10. Jena A., Таnega S., Talwar V.T., Sharma J.B. Magnetic resonance (MR) patterns of brain metastasis in lung cancer patients: correlation of imaging findings with symptom. J. Thorac. Oncol. 2008; 3 (2): 140–4.