Spinal computed tomography and computed tomographic metrizamide myelography in the early diagnosis of metastatic disease
New lesions were shown by Tc99m bone scans to have developed in sixty patients with known metastatic cancer or high-risk primary cancer and normal neurologic examinations; they were further evaluated with plain radiographs, spinal computed tomography (CT), and CT myelography (CT-M) according to an algorithm. Three groups were identified based on plain radiographs: group 1 (normal radiograph), group 2 (compression fracture as indicated by radiograph), group 3 (evidence of metastasis as indicated by radiograph). In group 1 (n = 18), spinal CT revealed that 33% of the patients had benign disease and 67%, metastases; epidural compression was seen in 25% of the patients with metastasis as indicated by CT-M. In group 2 (n = 26), CT-M disclosed that 38% had a benign compression fracture and 62% had metastases and that 63% of the patients with metastases had an epidural compression. In group 3 (n = 16), spinal CT revealed that 15 patients had metastases (one patient had benign disease). Epidural cord compression was seen in 47% of the patients with metastatic disease. In all groups, the presence of cortical bone discontinuity around the neural canal (seen in 31 patients) was highly associated with epidural compression (seen in 20 patients). Our approach allowed the early and accurate diagnosis of spinal metastasis and epidural tumor as well as the diagnosis of benign disease and was useful in planning optimal local therapy.
- Research Organization:
- Madigan Army Medical Center, Tacoma, WA
- OSTI ID:
- 5691114
- Journal Information:
- J. Clin. Oncol.; (United States), Journal Name: J. Clin. Oncol.; (United States) Vol. 4; ISSN JCOND
- Country of Publication:
- United States
- Language:
- English
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550602 -- Medicine-- External Radiation in Diagnostics-- (1980-)
62 RADIOLOGY AND NUCLEAR MEDICINE
AMIDES
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BIOMEDICAL RADIOGRAPHY
BODY
CENTRAL NERVOUS SYSTEM
COMPUTERIZED TOMOGRAPHY
CONTRAST MEDIA
COUNTING TECHNIQUES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DISEASES
HOURS LIVING RADIOISOTOPES
INTERMEDIATE MASS NUCLEI
ISOMERIC NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MEDICINE
METASTASES
METRIZAMIDE
NEOPLASMS
NERVOUS SYSTEM
NUCLEAR MEDICINE
NUCLEI
ODD-EVEN NUCLEI
ORGANIC COMPOUNDS
ORGANIC NITROGEN COMPOUNDS
ORGANS
PATIENTS
RADIOISOTOPE SCANNING
RADIOISOTOPES
RADIOLOGY
SKELETON
SPINAL CORD
TECHNETIUM 99
TECHNETIUM ISOTOPES
TOMOGRAPHY
YEARS LIVING RADIOISOTOPES