DOES BONE SPECT ACTUALLY HAVE LOWER SENSITIVITY FOR DETECTING VERTEBRAL METASTASIS THAN MRI

We compared the ability of bone SPECT and MRI to detect vertebral meta stasis. Methods: Skeletal scintigraphy, including planar and SPECT ima ging, and spinal MRI examinations, were performed in 22 cancer patient s in whom a total of 88 metastatic fool and 12 degenerative joint dise ase lesions were detected. Metastatic foci were defined as lesions tha t suggested metastasis on MRI and/or bone destruction on radiographs o r CT and/or aggravation of increased tracer uptakes on serial bone sca ns. Image reconstruction of axial, coronal and sagittal sections was p rocessed in a 128 x 128 matrix. MRI studies were performed with a 1.5 tesla signal scanner using fast spin-echo sequences. T1- and T2-weight ed images were obtained in the sagittal plane. Results: Twenty patient s had at least one vertebral metastasis. MRI diagnosed 86 of the 88 (9 7.7%) metastatic fool; bone SPECT correctly diagnosed 81 of 88 (92.0%) ; and planar imaging detected 62 of 88 (70.4%). The two vertebrae with metastasis not detected by MRI were dearly seen by bone SPECT. Extra- vertebral body metastases (e.g., in the pedicle, lamina, transverse an d spinous processes) were, however, most often detected by SPECT, foll owed by MRI and planar imaging (40 Versus 32 versus 4). Conclusion: Ve rtebral SPECT, using high-resolution SPECT equipment, produced excelle nt results that were comparable to acid complementary with MRI in dete cting vertebral metastasis. Our data suggest that vertebral SPECT is s uperior to MRI in detecting extra-vertebral body metastasis.