Rajesh Uddandam1 , Udaybhanu Kovilapu2 , Narendra Kumar Jain3 , Darshan Singh Grewal4 , Saikat Bhattacharjee5 , Saurabh Maheshwari6
BACKGROUND Vertebral metastases occur with many malignancies and initially tend to be intramedullary. It is imperative that vertebral metastases are detected early so that early initiation of treatment can be done. Magnetic resonance imaging may diagnose vertebral metastases in an early stage. The aim of this study was to compare the efficacy of Magnetic Resonance (MR) Imaging as against Radionuclide bone scans in early detection of vertebral metastases. METHODS 60 consecutive patients with a proven malignancy and clinical and laboratory suspicion of metastases were taken up for this study. The patients were subjected to MR Imaging and bone scan within 15 days of each other. The findings of MR imaging and bone scan were compared to see concordant and discordant lesions and were statistically analysed. RESULTS The sensitivity of MRI compared to bone scan, in the detection of vertebral metastases, was 97% and the specificity was 94%. Percentage of small sized lesions diagnosed by bone scan was significantly lower than the percentage of large size lesions diagnosed. Percentage of intramedullary and subcortical lesions diagnosed by bone scan was significantly lower than the percentage of transcortical lesions diagnosed. CONCLUSIONS MR imaging can pick up intramedullary metastases in vertebral bodies earlier than bone scan. Involvement of cortex of vertebral body is important for metastases to be picked up on bone scan.
