Skip to main content
Top
Published in: European Radiology 12/2012

01-12-2012 | Breast

Detection of incidental vertebral fractures in breast imaging: the potential role of MR localisers

Authors: Alberto Bazzocchi, Paolo Spinnato, Giorgio Garzillo, Federica Ciccarese, Ugo Albisinni, Stefano Mignani, Giuseppe Battista, Cristina Rossi

Published in: European Radiology | Issue 12/2012

Login to get access

Abstract

Objectives

Incidental diagnosis of vertebral fractures (VFs) may represent a key point in the assessment of bone health status. Our purpose was to retrospectively evaluate localisation sequences (MR-loc) of breast MRI as a potential tool to detect osteoporotic VFs.

Methods

MR-loc sagittal images of 856 breast MRIs were reviewed by three expert musculoskeletal radiologists with a semiquantitative approach to detecting VFs. Anamnesis and data of patients were investigated. Official breast MRI and previous imaging reports were checked to understand if VFs or other relevant bone findings were known in patients’ clinical history.

Results

A total of 780/856 female patients (91.1 %) undergoing MRI for oncological reasons and 76/856 (8.9 %) with non-oncological aims were recruited into the study (54.7 ± 12.2 years old, 21–89 years); 57/856 MR-loc images (6.7 %) were considered inadequate for diagnostic purposes and were excluded from the analysis. MR-loc detected VFs in 71/799 patients (8.9 %). VFs were neither reported nor previously known in the clinical history of 63/71 patients (88.7 %; P < 0.001). No mention of VFs was found in any breast MR reports. In four patients MR-loc identified vertebral metastases.

Conclusions

A systematic evaluation of MR-loc may offer additional clinical information to prevent unrecognised VFs. MR-loc may screen for VFs in other imaging settings.

Key Points

Vertebral fractures are usually a hallmark of osteoporosis.
Localisation sequences before breast MR examinations can identify vertebral fractures.
MR localisers should be inspected for vertebral fractures in other clinical settings.
Literature
1.
go back to reference Thompson RJ, Wojcik SM, Grant WD, Ko PY (2011) Incidental findings on CT scans in the emergency department. Emerg Med Int 2011:624847PubMed Thompson RJ, Wojcik SM, Grant WD, Ko PY (2011) Incidental findings on CT scans in the emergency department. Emerg Med Int 2011:624847PubMed
2.
go back to reference Johnson PT, Horton KM, Megibow AJ, Jeffrey RB, Fishman EK (2011) Common incidental findings on MDCT: survey of radiologist recommendations for patient management. J Am Coll Radiol 8:762–767PubMedCrossRef Johnson PT, Horton KM, Megibow AJ, Jeffrey RB, Fishman EK (2011) Common incidental findings on MDCT: survey of radiologist recommendations for patient management. J Am Coll Radiol 8:762–767PubMedCrossRef
3.
go back to reference Ensrud KE, Schousboe JT (2011) Clinical practice. Vertebral fractures. N Engl J Med 364:1634–1642PubMedCrossRef Ensrud KE, Schousboe JT (2011) Clinical practice. Vertebral fractures. N Engl J Med 364:1634–1642PubMedCrossRef
4.
go back to reference Eastell R, Cedel SL, Wahner HW, Riggs BL, Melton LJ 3rd (1991) Classification of vertebral fractures. J Bone Miner Res 6:207–215PubMedCrossRef Eastell R, Cedel SL, Wahner HW, Riggs BL, Melton LJ 3rd (1991) Classification of vertebral fractures. J Bone Miner Res 6:207–215PubMedCrossRef
5.
go back to reference Davies KM, Stegman MR, Heaney RP, Recker RR (1996) Prevalence and severity of vertebral fracture: the Saunders County Bone Quality Study. Osteoporos Int 6:160–165PubMedCrossRef Davies KM, Stegman MR, Heaney RP, Recker RR (1996) Prevalence and severity of vertebral fracture: the Saunders County Bone Quality Study. Osteoporos Int 6:160–165PubMedCrossRef
6.
go back to reference Pongchaiyakul C, Nguyen ND, Jones G, Center JR, Eisman JA, Nguyen TV (2005) Asymptomatic vertebral deformity as a major risk factor for subsequent fractures and mortality: a long-term prospective study. J Bone Miner Res 20:1349–1355PubMedCrossRef Pongchaiyakul C, Nguyen ND, Jones G, Center JR, Eisman JA, Nguyen TV (2005) Asymptomatic vertebral deformity as a major risk factor for subsequent fractures and mortality: a long-term prospective study. J Bone Miner Res 20:1349–1355PubMedCrossRef
7.
go back to reference Klotzbuecher CM, Ross PD, Landsman PB, Abbott TA 3rd, Berger M (2000) Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res 15:721–739PubMedCrossRef Klotzbuecher CM, Ross PD, Landsman PB, Abbott TA 3rd, Berger M (2000) Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res 15:721–739PubMedCrossRef
8.
go back to reference Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A (2007) Incidence and economic burden of osteoporosis-related fractures in the United States, 2005-2025. J Bone Miner Res 22:465–475PubMedCrossRef Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A (2007) Incidence and economic burden of osteoporosis-related fractures in the United States, 2005-2025. J Bone Miner Res 22:465–475PubMedCrossRef
9.
go back to reference Kanis JA, Johnell O (2005) Requirements for DXA for the management of osteoporosis in Europe. Osteoporos Int 16:229–238PubMedCrossRef Kanis JA, Johnell O (2005) Requirements for DXA for the management of osteoporosis in Europe. Osteoporos Int 16:229–238PubMedCrossRef
10.
go back to reference Gehlbach SH, Bigelow C, Heimisdottir M, May S, Walker M, Kirkwood JR (2000) Recognition of vertebral fracture in a clinical setting. Osteoporos Int 11:577–582PubMedCrossRef Gehlbach SH, Bigelow C, Heimisdottir M, May S, Walker M, Kirkwood JR (2000) Recognition of vertebral fracture in a clinical setting. Osteoporos Int 11:577–582PubMedCrossRef
11.
go back to reference Muller D, Bauer JS, Zeile M, Rummeny EJ, Link TM (2008) Significance of sagittal reformations in routine thoracic and abdominal multislice CT studies for detecting osteoporotic fractures and other spine abnormalities. Eur Radiol 18:1696–1702PubMedCrossRef Muller D, Bauer JS, Zeile M, Rummeny EJ, Link TM (2008) Significance of sagittal reformations in routine thoracic and abdominal multislice CT studies for detecting osteoporotic fractures and other spine abnormalities. Eur Radiol 18:1696–1702PubMedCrossRef
12.
go back to reference Bazzocchi A, Spinnato P, Albisinni U, Battista G, Rossi C, Guglielmi G (2011) A careful evaluation of scout CT lateral radiograph may prevent unreported vertebral fractures. Eur J Radiol. doi:10.1016/j.ejrad.2011.08.015 Bazzocchi A, Spinnato P, Albisinni U, Battista G, Rossi C, Guglielmi G (2011) A careful evaluation of scout CT lateral radiograph may prevent unreported vertebral fractures. Eur J Radiol. doi:10.​1016/​j.​ejrad.​2011.​08.​015
13.
go back to reference Williams AL, Al-Busaidi A, Sparrow PJ, Adams JE, Whitehouse RW (2009) Under-reporting of osteoporotic vertebral fractures on computed tomography. Eur J Radiol 69:179–183PubMedCrossRef Williams AL, Al-Busaidi A, Sparrow PJ, Adams JE, Whitehouse RW (2009) Under-reporting of osteoporotic vertebral fractures on computed tomography. Eur J Radiol 69:179–183PubMedCrossRef
14.
go back to reference Delmas PD, van de Langerijt L, Watts NB et al (2005) Underdiagnosis of vertebral fractures is a worldwide problem: the IMPACT study. J Bone Miner Res 20:557–563PubMedCrossRef Delmas PD, van de Langerijt L, Watts NB et al (2005) Underdiagnosis of vertebral fractures is a worldwide problem: the IMPACT study. J Bone Miner Res 20:557–563PubMedCrossRef
15.
go back to reference Genant HK, Wu CY, van Kuijk C, Nevitt MC (1993) Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res 8:1137–1148PubMedCrossRef Genant HK, Wu CY, van Kuijk C, Nevitt MC (1993) Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res 8:1137–1148PubMedCrossRef
16.
go back to reference Sardanelli F, Boetes C, Borisch B et al (2010) Magnetic resonance imaging of the breast: recommendations from the EUSOMA working group. Eur J Cancer 46:1296–1316PubMedCrossRef Sardanelli F, Boetes C, Borisch B et al (2010) Magnetic resonance imaging of the breast: recommendations from the EUSOMA working group. Eur J Cancer 46:1296–1316PubMedCrossRef
17.
go back to reference Kim YM, Demissie S, Genant HK et al (2011) Identification of prevalent vertebral fractures using CT lateral scout views: a comparison of semi-automated quantitative vertebral morphometry and radiologist semi-quantitative grading. Osteoporos Int 23:1007–1016PubMedCrossRef Kim YM, Demissie S, Genant HK et al (2011) Identification of prevalent vertebral fractures using CT lateral scout views: a comparison of semi-automated quantitative vertebral morphometry and radiologist semi-quantitative grading. Osteoporos Int 23:1007–1016PubMedCrossRef
18.
go back to reference Kim YM, Demissie S, Eisenberg R, Samelson EJ, Kiel DP, Bouxsein ML (2011) Intra-and inter-reader reliability of semi-automated quantitative morphometry measurements and vertebral fracture assessment using lateral scout views from computed tomography. Osteoporos Int 22:2677–2688PubMedCrossRef Kim YM, Demissie S, Eisenberg R, Samelson EJ, Kiel DP, Bouxsein ML (2011) Intra-and inter-reader reliability of semi-automated quantitative morphometry measurements and vertebral fracture assessment using lateral scout views from computed tomography. Osteoporos Int 22:2677–2688PubMedCrossRef
19.
go back to reference Samelson EJ, Christiansen BA, Demissie S et al (2011) Reliability of vertebral fracture assessment using multidetector CT lateral scout views: the Framingham Osteoporosis Study. Osteoporos Int 22:1123–1131PubMedCrossRef Samelson EJ, Christiansen BA, Demissie S et al (2011) Reliability of vertebral fracture assessment using multidetector CT lateral scout views: the Framingham Osteoporosis Study. Osteoporos Int 22:1123–1131PubMedCrossRef
20.
go back to reference Tehranzadeh J, Tao C (2004) Advances in MR imaging of vertebral collapse. Semin Ultrasound CT MR 25:440–460PubMedCrossRef Tehranzadeh J, Tao C (2004) Advances in MR imaging of vertebral collapse. Semin Ultrasound CT MR 25:440–460PubMedCrossRef
22.
go back to reference Pfeilschifter J, Diel IJ (2000) Osteoporosis due to cancer treatment: pathogenesis and management. J Clin Oncol 18:1570–1593PubMed Pfeilschifter J, Diel IJ (2000) Osteoporosis due to cancer treatment: pathogenesis and management. J Clin Oncol 18:1570–1593PubMed
23.
go back to reference Reid IR (1998) Glucocorticoid-induced osteoporosis: assessment and treatment. J Clin Densitom 1:65–73PubMedCrossRef Reid IR (1998) Glucocorticoid-induced osteoporosis: assessment and treatment. J Clin Densitom 1:65–73PubMedCrossRef
24.
go back to reference Cataldi V, Laporta T, Sverzellati N, De Filippo M, Zompatori M (2008) Detection of incidental vertebral fractures on routine lateral chest radiographs. Radiol Med 113:968–977PubMedCrossRef Cataldi V, Laporta T, Sverzellati N, De Filippo M, Zompatori M (2008) Detection of incidental vertebral fractures on routine lateral chest radiographs. Radiol Med 113:968–977PubMedCrossRef
25.
go back to reference Guglielmi G, Muscarella S, Bazzocchi A (2011) Integrated imaging approach to osteoporosis: state-of-the-art review and update. Radiographics 31:1343–1364PubMedCrossRef Guglielmi G, Muscarella S, Bazzocchi A (2011) Integrated imaging approach to osteoporosis: state-of-the-art review and update. Radiographics 31:1343–1364PubMedCrossRef
26.
go back to reference Fleurence RL (2004) Cost-effectiveness of fracture prevention treatments in the elderly. Int J Technol Assess Health Care 20:184–191PubMedCrossRef Fleurence RL (2004) Cost-effectiveness of fracture prevention treatments in the elderly. Int J Technol Assess Health Care 20:184–191PubMedCrossRef
27.
go back to reference Harvey N, Dennison E, Cooper C (2010) Osteoporosis: impact on health and economics. Nat Rev Rheumatol 6:99–105PubMedCrossRef Harvey N, Dennison E, Cooper C (2010) Osteoporosis: impact on health and economics. Nat Rev Rheumatol 6:99–105PubMedCrossRef
Metadata
Title
Detection of incidental vertebral fractures in breast imaging: the potential role of MR localisers
Authors
Alberto Bazzocchi
Paolo Spinnato
Giorgio Garzillo
Federica Ciccarese
Ugo Albisinni
Stefano Mignani
Giuseppe Battista
Cristina Rossi
Publication date
01-12-2012
Publisher
Springer-Verlag
Published in
European Radiology / Issue 12/2012
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-012-2521-3

Other articles of this Issue 12/2012

European Radiology 12/2012 Go to the issue