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01-07-2013 | Oncology

MRI for response assessment in metastatic bone disease

Authors: F. E. Lecouvet, A. Larbi, V. Pasoglou, P. Omoumi, B. Tombal, N. Michoux, J. Malghem, R. Lhommel, B. C. Vande Berg

Published in: European Radiology | Issue 7/2013

Abstract

Background

Beyond lesion detection and characterisation, and disease staging, the quantification of the tumour load and assessment of response to treatment are daily expectations in oncology.

Methods

Bone lesions have been considered “non-measurable” for years as opposed to lesions involving soft tissues and “solid” organs like the lungs or liver, for which response evaluation criteria are used in every day practice. This is due to the lack of sensitivity, specificity and measurement capabilities of imaging techniques available for bone assessment, i.e. skeletal scintigraphy (SS), radiographs and computed tomography (CT).

Results

This paper reviews the possibilities and limitations of these techniques and highlights the possibilities of positron emission tomography (PET), but mainly concentrates on magnetic resonance imaging (MRI).

Conclusion

Practical morphological and quantitative approaches are proposed to evaluate the treatment response of bone marrow lesions using “anatomical” MRI. Recent developments of MRI, i.e. dynamic contrast-enhanced (DCE) imaging and diffusion-weighted imaging (DWI), are also covered.

Key Points

• MRI offers improved evaluation of skeletal metastases and their response to treatment.

• This new indication for MRI has wide potential impact on radiological practice.

• MRI helps meet the expectations of the oncological community.

• We emphasise the practical aspects, with didactic cases and illustrations.

Therasse P, Arbuck SG, Eisenhauer EA et al (2000) New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 92:205–216PubMedCrossRef

Scher HI, Morris MJ, Basch E, Heller G (2011) Endpoints and outcomes in castration-resistant prostate cancer: from clinical trials to clinical practice. J Clin Oncol 29:3695–3704PubMedCrossRef

Gosfield E 3rd, Alavi A, Kneeland B (1993) Comparison of radionuclide bone scans and magnetic resonance imaging in detecting spinal metastases. J Nucl Med 34:2191–2198PubMed

Lecouvet FE, Geukens D, Stainier A et al (2007) Magnetic resonance imaging of the axial skeleton for detecting bone metastases in patients with high-risk prostate cancer: diagnostic and cost-effectiveness and comparison with current detection strategies. J Clin Oncol 25:3281–3287PubMedCrossRef

Ciray I, Astrom G, Andreasson I et al (2000) Evaluation of new sclerotic bone metastases in breast cancer patients during treatment. Acta Radiol 41:178–182PubMedCrossRef

Messiou C, Cook G, deSouza NM (2009) Imaging metastatic bone disease from carcinoma of the prostate. Br J Cancer 101:1225–1232PubMedCrossRef

Even-Sapir E, Metser U, Mishani E, Lievshitz G, Lerman H, Leibovitch I (2006) The detection of bone metastases in patients with high-risk prostate cancer: 99mTc-MDP planar bone scintigraphy, single- and multi-field-of-view SPECT, 18F-fluoride PET, and 18F-fluoride PET/CT. J Nucl Med 47:287–297PubMed

Galasko CS (1995) Diagnosis of skeletal metastases and assessment of response to treatment. Clin Orthop Relat Res 312:64–75

Hamaoka T, Madewell JE, Podoloff DA, Hortobagyi GN, Ueno NT (2004) Bone imaging in metastatic breast cancer. J Clin Oncol 22:2942–2953PubMedCrossRef

10.

Lecouvet FE, Malghem J, Michaux L et al (1999) Skeletal survey in advanced multiple myeloma: radiographic versus MR imaging survey. Br J Haematol 106:35–39PubMedCrossRef

11.

Moulopoulos LA, Dimopoulos MA, Alexanian R, Leeds NE, Libshitz HI (1994) Multiple myeloma: MR patterns of response to treatment. Radiology 193:441–446PubMed

12.

Groves AM, Beadsmoore CJ, Cheow HK et al (2006) Can 16-detector multislice CT exclude skeletal lesions during tumour staging? Implications for the cancer patient. Eur Radiol 16:1066–1073PubMedCrossRef

13.

Bauerle T, Semmler W (2009) Imaging response to systemic therapy for bone metastases. Eur Radiol 19:2495–2507PubMedCrossRef

14.

Yang HL, Liu T, Wang XM, Xu Y, Deng SM (2011) Diagnosis of bone metastases: a meta-analysis comparing (18)FDG PET, CT, MRI and bone scintigraphy. Eur Radiol 21:2604–2617PubMedCrossRef

15.

Antoch G, Vogt FM, Freudenberg LS et al (2003) Whole-body dual-modality PET/CT and whole-body MRI for tumor staging in oncology. JAMA 290:3199–3206PubMedCrossRef

16.

Stafford SE, Gralow JR, Schubert EK et al (2002) Use of serial FDG PET to measure the response of bone-dominant breast cancer to therapy. Acad Radiol 9:913–921PubMedCrossRef

17.

Tateishi U, Gamez C, Dawood S, Yeung HW, Cristofanilli M, Macapinlac HA (2008) Bone metastases in patients with metastatic breast cancer: morphologic and metabolic monitoring of response to systemic therapy with integrated PET/CT. Radiology 247:189–196PubMedCrossRef

18.

De Giorgi U, Mego M, Rohren EM et al (2010) 18F-FDG PET/CT findings and circulating tumor cell counts in the monitoring of systemic therapies for bone metastases from breast cancer. J Nucl Med 51:1213–1218PubMedCrossRef

19.

Du Y, Cullum I, Illidge TM, Ell PJ (2007) Fusion of metabolic function and morphology: sequential [18F]fluorodeoxyglucose positron-emission tomography/computed tomography studies yield new insights into the natural history of bone metastases in breast cancer. J Clin Oncol 25:3440–3447PubMedCrossRef

20.

Shankar LK, Hoffman JM, Bacharach S et al (2006) Consensus recommendations for the use of 18F-FDG PET as an indicator of therapeutic response in patients in National Cancer Institute Trials. J Nucl Med 47:1059–1066PubMed

21.

Vande Berg BC, Lecouvet FE, Michaux L, Ferrant A, Maldague B, Malghem J (1998) Magnetic resonance imaging of the bone marrow in hematological malignancies. Eur Radiol 8:1335–1344PubMedCrossRef

22.

Daldrup-Link HE, Franzius C, Link TM et al (2001) Whole-body MR imaging for detection of bone metastases in children and young adults: comparison with skeletal scintigraphy and FDG PET. AJR Am J Roentgenol 177:229–236PubMedCrossRef

23.

Ghanem N, Uhl M, Brink I et al (2005) Diagnostic value of MRI in comparison to scintigraphy, PET, MS-CT and PET/CT for the detection of metastases of bone. Eur J Radiol 55:41–55PubMedCrossRef

24.

Schmidt GP, Schoenberg SO, Schmid R et al (2007) Screening for bone metastases: whole-body MRI using a 32-channel system versus dual-modality PET-CT. Eur Radiol 17:939–949PubMedCrossRef

25.

Vande Berg BC, Lecouvet FE, Galant C, Maldague BE, Malghem J (2005) Normal variants and frequent marrow alterations that simulate bone marrow lesions at MR imaging. Radiol Clin N Am 43:761–770PubMedCrossRef

26.

Tombal B, Rezazadeh A, Therasse P, Van Cangh PJ, Vande Berg B, Lecouvet FE (2005) Magnetic resonance imaging of the axial skeleton enables objective measurement of tumor response on prostate cancer bone metastases. Prostate 65:178–187PubMedCrossRef

27.

Lecouvet FE, Simon M, Tombal B, Jamart J, Vande Berg BC, Simoni P (2010) Whole-body MRI (WB-MRI) versus axial skeleton MRI (AS-MRI) to detect and measure bone metastases in prostate cancer (PCa). Eur Radiol 20:2973–2982PubMedCrossRef

28.

Lecouvet FE, El Mouedden J, Collette L et al (2012) Can whole-body magnetic resonance imaging with diffusion-weighted imaging replace Tc 99m bone scanning and computed tomography for single-step detection of metastases in patients with high-risk prostate cancer? Eur Urol. doi:10.1016/j.eururo.2012.02.020

29.

Schmidt GP, Reiser MF, Baur-Melnyk A (2009) Whole-body MRI for the staging and follow-up of patients with metastasis. Eur J Radiol 70:393–400PubMedCrossRef

30.

Baur-Melnyk A, Buhmann S, Becker C et al (2008) Whole-body MRI versus whole-body MDCT for staging of multiple myeloma. AJR Am J Roentgenol 190:1097–1104PubMedCrossRef

31.

Lecouvet FE, De Nayer P, Garbar C et al (1998) Treated plasma cell lesions of bone with MRI signs of response to treatment: unexpected pathological findings. Skeletal Radiol 27:692–695PubMedCrossRef

32.

Malghem J, Vande Berg B, Noël H, Maldague B (1995) Imagerie de la moelle normale et de ses variations. In: S. Sintzoff, J.D Laredo, M. Caroit (eds) Imagerie de l’os et de la moelle osseuse, Getroa Opus XXII, Sauramps Medical Montpellier pp 123–134

33.

Hwang S, Panicek DM (2007) Magnetic resonance imaging of bone marrow in oncology, Part 2. Skeletal Radiol 36:1017–1027PubMedCrossRef

34.

Ryan SP, Weinberger E, White KS et al (1995) MR imaging of bone marrow in children with osteosarcoma: effect of granulocyte colony-stimulating factor. AJR Am J Roentgenol 165:915–920PubMedCrossRef

35.

Ciray I, Lindman H, Astrom KG, Bergh J, Ahlstrom KH (2001) Early response of breast cancer bone metastases to chemotherapy evaluated with MRI. Acta Radiol 42:198–206PubMed

36.

Saip P, Tenekeci N, Aydiner A et al (1999) Response evaluation of bone metastases in breast cancer: value of magnetic resonance imaging. Cancer Investig 17:575–580CrossRef

37.

Padhani AR, Koh DM (2011) Diffusion MR imaging for monitoring of treatment response. Magn Reson Imaging Clin N Am 19:181–209PubMedCrossRef

38.

Lecouvet FE, Vande Berg BC, Malghem J, Omoumi P, Simoni P (2009) Diffusion-weighted MR imaging: adjunct or alternative to T1-weighted MR imaging for prostate carcinoma bone metastases? Radiology 252:624PubMedCrossRef

39.

Koh DM, Takahara T, Imai Y, Collins DJ (2007) Practical aspects of assessing tumors using clinical diffusion-weighted imaging in the body. Magn Reson Med Sci 6:211–224PubMedCrossRef

40.

Charles-Edwards EM, deSouza NM (2006) Diffusion-weighted MRI and its application to cancer. Cancer Imaging 6:135–143PubMedCrossRef

41.

Reischauer C, Froehlich JM, Koh DM et al (2010) Bone metastases from prostate cancer: assessing treatment response by using diffusion-weighted imaging and functional diffusion maps—initial observations. Radiology 257:523–531PubMedCrossRef

42.

Messiou C, Collins DJ, Giles S, de Bono JS, Bianchini D, de Souza NM (2011) Assessing response in bone metastases in prostate cancer with diffusion weighted MRI. Eur Radiol 21:2169–2177PubMedCrossRef

43.

Koh DM, Blackledge M, Collins DJ et al (2009) Reproducibility and changes in the apparent diffusion coefficients of solid tumours treated with combretastatin A4 phosphate and bevacizumab in a two-centre phase I clinical trial. Eur Radiol 19:2728–2738PubMedCrossRef

44.

Vassiliou V, Andreopoulos D, Frangos S, Tselis N, Giannopoulou E, Lutz S (2011) Bone metastases: assessment of therapeutic response through radiological and nuclear medicine imaging modalities. Clin Oncol 23:632–645CrossRef

45.

Biffar A, Sourbron S, Schmidt G et al (2010) Measurement of perfusion and permeability from dynamic contrast-enhanced MRI in normal and pathological vertebral bone marrow. Magn Reson Med 64:115–124PubMedCrossRef

46.

O’Connor JP, Jackson A, Parker GJ, Jayson GC (2007) DCE-MRI biomarkers in the clinical evaluation of antiangiogenic and vascular disrupting agents. Br J Cancer 96:189–195PubMedCrossRef

47.

Bauerle T, Merz M, Komljenovic D, Zwick S, Semmler W (2010) Drug-induced vessel remodeling in bone metastases as assessed by dynamic contrast enhanced magnetic resonance imaging and vessel size imaging: a longitudinal in vivo study. Clin Cancer Res 16:3215–3225PubMedCrossRef

48.

Tofts PS, Brix G, Buckley DL et al (1999) Estimating kinetic parameters from dynamic contrast-enhanced T(1)-weighted MRI of a diffusable tracer: standardized quantities and symbols. J Magn Reson Imaging 10:223–232PubMedCrossRef

Title: MRI for response assessment in metastatic bone disease
Authors: F. E. Lecouvet
A. Larbi
V. Pasoglou
P. Omoumi
B. Tombal
N. Michoux
J. Malghem
R. Lhommel
B. C. Vande Berg
Publication date: 01-07-2013
Publisher: Springer-Verlag
Published in: European Radiology / Issue 7/2013
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-013-2792-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

MRI for response assessment in metastatic bone disease

Abstract

Background

Methods

Results

Conclusion

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Key Points

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