Special Issue "Imaging of Bone Metastases in Oncology"

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging".

Deadline for manuscript submissions: closed (31 January 2018)

Special Issue Editors

Guest Editor
Prof. Lars J. Petersen

Department of Nuclear Medicine, Aalborg University Hospital, and Department of Clinical Medicine, The Faculty of Medicine, Aalborg University, Aalborg, Denmark
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Interests: prostate cancer imaging; bone imaging; oncology; evidence based medicine; research methodology; systematic reviews and meta-analysis
Guest Editor
Assoc. Prof. Helle D. Zacho

Department of Nuclear Medicine, Aalborg University Hospital, Aalborg; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Special Issue Information

Dear Colleagues,

Bone metastases are well known complications to advanced cancer, e.g., in common cancers like prostate, breast, and lung cancer. Imaging of bone metastases are key in staging, suspected recurrent disease, and for treatment monitoring of palliative care in metastatic disease. Imaging modalities like bone scintigraphy, X-ray, and CT have standard of care in the last decades. Newer modalities like PET/CT with various tracers and diffusion-weighed MRI have been introduced with apparent premium diagnostic performance. Modern imaging modalities also offer opportunities for quantitative analysis of bone lesions with improved prognostic values. Improved detection rates raise the question of stage migration, e.g., how to define and treat oligometastatic disease. From a diagnostic test accuracy perspective, bone metastases may be difficult to handle for several reasons, including failure to obtain a valid reference for the presence or absence of maliognancy, in particular at the lesional level. This Special Issue provides an up to date view of the advances made towards imaging of bone metastases in oncology. It canvasses all fields and modalities of imaging of bone metastases, from diagnosis, prognosis, comparative studies with other biomarkers, research methodology, health care analyses, and guidelines.

Prof. Lars J. Petersen
Assoc. Prof. Helle D. Zacho
Guest Editors

Manuscript Submission Information

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Keywords

  • Bone metastases
  • Oncology
  • Diagnostic test accuracy studies
  • Imaging
  • PET/CT
  • Diffusion-weighted MRI
  • Image quantification
  • Research methodology
  • Guidelines
  • Health care outcome

Published Papers (5 papers)

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Research

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Open AccessArticle Reporting and Handling of Indeterminate Bone Scan Results in the Staging of Prostate Cancer: A Systematic Review
Received: 29 December 2017 / Revised: 10 January 2018 / Accepted: 12 January 2018 / Published: 16 January 2018
Cited by 1 | PDF Full-text (636 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Bone scintigraphy is key in imaging skeletal metastases in newly diagnosed prostate cancer. Unfortunately, a notable proportion of scans are not readily classified as positive or negative but deemed indeterminate. The extent of reporting of indeterminate bone scans and how such scans are
[...] Read more.
Bone scintigraphy is key in imaging skeletal metastases in newly diagnosed prostate cancer. Unfortunately, a notable proportion of scans are not readily classified as positive or negative but deemed indeterminate. The extent of reporting of indeterminate bone scans and how such scans are handled in clinical trials are not known. A systematic review was conducted using electronic databases up to October 2016. The main outcome of interest was the reporting of indeterminate bone scans, analyses of how such scans were managed, and exploratory analyses of the association of study characteristics and the reporting of indeterminate bone scan results. Seventy-four eligible clinical trials were identified. The trials were mostly retrospective (85%), observational (95%), large trials (median 195 patients) from five continents published over four decades. The majority of studies had university affiliation (72%), and an author with imaging background (685). Forty-five studies (61%) reported an indeterminate option for the bone scan and 23 studies reported the proportion of indeterminate scans (median 11.4%). Most trials (44/45, 98%) reported how to handle indeterminate scans. Most trials (n = 39) used add-on supplementary imaging, follow-up bone scans, or both. Exploratory analyses showed a significant association of reporting of indeterminate results and number of patients in the study (p = 0.024) but failed to reach statistical significance with other variables tested. Indeterminate bone scan for staging of prostate cancer was insufficiently reported in clinical trials. In the case of indeterminate scans, most studies provided adequate measures to obtain the final status of the patients. Full article
(This article belongs to the Special Issue Imaging of Bone Metastases in Oncology)
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Open AccessArticle Prospective Comparison of F-18 Choline PET/CT Scan Versus Axial MRI for Detecting Bone Metastasis in Biochemically Relapsed Prostate Cancer Patients
Diagnostics 2017, 7(4), 56; https://doi.org/10.3390/diagnostics7040056
Received: 22 September 2017 / Revised: 9 October 2017 / Accepted: 14 October 2017 / Published: 17 October 2017
Cited by 2 | PDF Full-text (433 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
We compared fluor-18 choline positron emission tomography/computed tomography (PET/CT) and axial skeleton magnetic resonance imaging (MRI) prospectively obtained for the detection of bone metastases in non-castrated patients with biochemically recurrent prostate cancer following primary treatment. PET/CT was performed 45 min post-injection of 3–4
[...] Read more.
We compared fluor-18 choline positron emission tomography/computed tomography (PET/CT) and axial skeleton magnetic resonance imaging (MRI) prospectively obtained for the detection of bone metastases in non-castrated patients with biochemically recurrent prostate cancer following primary treatment. PET/CT was performed 45 min post-injection of 3–4 MBq/kg F-18 methyl choline. MRI included T1- and fluid sensitive T2-weighted images of the spine and pelvis. Readers were initially blinded from other results and all scans underwent independent double reading. The best valuable comparator (BVC) defined the metastatic status. On the basis of the BVC, 15 out of 64 patients presented with 24 bone metastases. On a patient level, the sensitivity and specificity of MRI and PET were not significantly different. On a lesion level, the sensitivity of MRI was significantly better compared to PET, and the specificity did not differ significantly. In conclusion, axial MRI is an interesting screening tool for the detection of bone metastases because of its low probability of false negative results. However, F-18 choline PET is a valuable addition as it can overrule false positive MRI results and detect non-axial metastases. Full article
(This article belongs to the Special Issue Imaging of Bone Metastases in Oncology)
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Review

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Open AccessReview Whole-Body MRI with Diffusion-Weighted Imaging in Bone Metastases: A Narrative Review
Diagnostics 2018, 8(3), 45; https://doi.org/10.3390/diagnostics8030045
Received: 4 April 2018 / Revised: 29 May 2018 / Accepted: 4 July 2018 / Published: 9 July 2018
PDF Full-text (1441 KB) | HTML Full-text | XML Full-text
Abstract
Whole body magnetic resonance imaging (MRI) with diffusion-weighted imaging (WB-MRI-DWI) is currently emerging as a diagnostic technique in the evaluation of bone metastases from breast, prostate, lung, thyroid, and melanoma tumors. The most relevant articles regarding the detection of solid tumor bone metastases
[...] Read more.
Whole body magnetic resonance imaging (MRI) with diffusion-weighted imaging (WB-MRI-DWI) is currently emerging as a diagnostic technique in the evaluation of bone metastases from breast, prostate, lung, thyroid, and melanoma tumors. The most relevant articles regarding the detection of solid tumor bone metastases with MRI have been reviewed and cited. The imaging methods currently used in the detection of bone metastases are bone scintigraphy, computed tomography (CT), and positron emission tomography (PET/CT) with 2-deoxy-2-[fluorine-18] fluoro-d-glucose (18F-FDG PET/CT). WB-MRI-DWI allows qualitative and quantitative evaluation of focal lesions through signal intensity evaluation on DWI images and the reconstruction of the apparent diffusion coefficient (ADC) map. In prostate and breast cancer, WB-MRI-DWI is useful in assessing the response of bone lesions to therapy and to detecting early non-responders, while in lung cancer the method shows a similar sensitivity to 18F-FDG PET/CT in the detection of bone metastases. In bone metastases of thyroid tumors and melanoma, the WB-MRI-DWI shows a higher sensitivity when compared to 18F-FDG PET/CT. With a standardization of the WB-MRI-DWI protocol, this method seems to play an important role in the diagnosis of bone solid tumor metastases. Full article
(This article belongs to the Special Issue Imaging of Bone Metastases in Oncology)
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Open AccessReview Percutaneous, Imaging-Guided Biopsy of Bone Metastases
Diagnostics 2018, 8(2), 25; https://doi.org/10.3390/diagnostics8020025
Received: 20 January 2018 / Revised: 10 April 2018 / Accepted: 16 April 2018 / Published: 18 April 2018
PDF Full-text (916 KB) | HTML Full-text | XML Full-text
Abstract
Approximately 70% of cancer patients will eventually develop bone metastases. Spine, due to the abundance of red marrow in the vertebral bodies and the communication of deep thoracic-pelvic veins with valve-less vertebral venous plexuses, is the most common site of osseous metastatic disease.
[...] Read more.
Approximately 70% of cancer patients will eventually develop bone metastases. Spine, due to the abundance of red marrow in the vertebral bodies and the communication of deep thoracic-pelvic veins with valve-less vertebral venous plexuses, is the most common site of osseous metastatic disease. Open biopsies run the risk of destabilizing an already diseased spinal or peripheral skeleton segment. Percutaneous biopsies obviate such issues and provide immediate confirmation of correct needle location in the area of interest. Indications for percutaneous bone biopsy include lesion characterization, optimal treatment and tumor recurrence identification, as well as tumor response and recurrence rate prediction. Predicting recurrence in curative cases could help in treatment stratification, identification, and validation of new targets. The overall accuracy of percutaneous biopsy is 90–95%; higher positive recovery rates govern biopsy of osteolytic lesions. The rate of complications for percutaneous biopsy approaches is <5%. The purpose of this review is to provide information about performing bone biopsy and what to expect from it as well as choosing the appropriate imaging guidance. Additionally, factors governing the appropriate needle trajectory that would likely give the greatest diagnostic yield and choice of the most appropriate biopsy system and type of anesthesia will be addressed. Full article
(This article belongs to the Special Issue Imaging of Bone Metastases in Oncology)
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Other

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Open AccessCase Report Dosimetry-Based Consideration on Remission and Relapse after Therapy with 223Ra-Dichloride in Castration-Resistant Prostate Cancer (CRPC) with Bone Metastases. A Case Report
Diagnostics 2018, 8(1), 18; https://doi.org/10.3390/diagnostics8010018
Received: 29 January 2018 / Revised: 20 February 2018 / Accepted: 24 February 2018 / Published: 27 February 2018
Cited by 1 | PDF Full-text (2169 KB) | HTML Full-text | XML Full-text
Abstract
Here, we present the case of a 64-year-old male patient diagnosed with castration-resistant prostate cancer (CRPC) with bone metastasis, treated with abiraterone prednisone/prednisolone in combination with 223Ra-dichloride therapy, who had remission and a subsequent relapse of bone metastasis on repeated bone scans
[...] Read more.
Here, we present the case of a 64-year-old male patient diagnosed with castration-resistant prostate cancer (CRPC) with bone metastasis, treated with abiraterone prednisone/prednisolone in combination with 223Ra-dichloride therapy, who had remission and a subsequent relapse of bone metastasis on repeated bone scans after therapy. We also discuss the possibility of continuing the 223Ra-dichloride therapy over the six planned administrations by administering other cycles at the same dose or at higher doses, if shown to be devoid of a significant increase in side effects, based on dosimetry considerations. Full article
(This article belongs to the Special Issue Imaging of Bone Metastases in Oncology)
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