Traditional imaging methods used in the detection and evaluation of me
tastatic bone disease lack either sensitivity (plain radiography) or s
pecificity (bone scintigraphy). Magnetic resonance imaging now has bee
n shown to be the most sensitive imaging technique available for the d
etection of bone metastases. On T1-weighted images bone metastases ten
d to stand out as focal or diffuse hypointense (dark) lesions against
a background of higher-signal-intensity marrow. Use of fat suppression
techniques may further increase the conspicuity of metastatic lesions
, Magnetic resonance imaging is unlikely to replace bone scintigraphy
as an initial screening technique for bone metastases because scintigr
aphy can image the whole skeleton quickly and at relatively low cost.
Magnetic resonance is particularly useful for imaging the spine becaus
e vertebral bodies, paraspinal, and intraspinal soft tissues can be ev
aluated, providing a noninvasive method of detection of spinal cord co
mpression. Magnetic resonance imaging also is useful in discriminating
between benign and malignant vertebral collapse.