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Диагностика метастатического поражения скелета у больных раком молочной железы: сравнительная оценка МРТ всего тела и сцинтиграфии скелета

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Diagnostics of Metastatic Disease of Skeleton at Patients with a Breast Cancer: Comparative Estimation Whole Body MRI and Scintigraphy of Skeleton

Diagnostic efficacy of whole body MRI (WB MRI) in detection of bone metastasis of breast cancer was estimated in comparison with scintigraphy of skeleton (SS). Thirty three patients with known BC were undergone both SS with Tc 99m-Technefor, and WB MRI by consecutive scanning of three anatomic areas: head and proximal parts of shoulders, thorax and abdomen, pelvis and proximal parts of hips at 1.5T unit using T1 weight imaging and STIR sequence in the coronal plane. For evaluation, ten zones of skeleton were defined: skull, cervical spine, thoracic spine, lumbar spine, pelvis, ribs, sternum, clavicles and scapulas, proximal part of humerus, proximal part of femur. Skeletal metastases were detected with both WB MRI, and SS at 24 of 33 patients. However from 126 verified metastatic zones, 114 zones (90 %) were detected with WB MRI, and 87 zones (69 %) – with SS. WB MRI was superior SS in detection of metastases in the majority of zones of skeleton except ribs and skull. Accuracy of diagnostics was estimated as the area under ROC curve, which was 0,951 ± 0,016 for WB MRI and 0,821 ± 0,026 for SS. At WB MRI it was in addition revealed metastases of a liver (8), a brain (2) and lung (1). Thus, our variant WB MRI is more efficient in detecting bone metastases, then SS, in the majority of zones of a skeleton, except of ribs and skull, and in addition allows revealing metastases in other organs.

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