Bone Metastases: Mechanisms of the Metastatic Process, Imaging and Therapy

Semin Ultrasound CT MR. 2021 Apr;42(2):164-183. doi: 10.1053/j.sult.2020.08.016. Epub 2020 Aug 29.

Abstract

The mechanisms by which tumors metastasize to bone are complex. Upon the successful establishment of metastatic deposits in the skeleton, detection of the disease becomes essential for therapeutic planning. The roles of CT, skeletal scintigraphy, SPECT/CT, MRI, PET/CT and PET/MRI will be reviewed. Therapeutic response criteria specifically designed to evaluate bone metastases (MD Anderson/MDA criteria) can guide image interpretation. Knowledge of therapeutic strategies such as systemic therapy with bisphosphonates or radiopharmaceuticals, radiation therapy, surgery, and percutaneous interventions such as vertebroplasty and radiofrequency ablation can help the radiologist produce reports that will provide maximum benefit to clinicians and patients.

MeSH terms

  • Bone Neoplasms* / diagnostic imaging
  • Bone Neoplasms* / therapy
  • Humans
  • Magnetic Resonance Imaging
  • Positron Emission Tomography Computed Tomography*
  • Radiopharmaceuticals
  • Tomography, X-Ray Computed

Substances

  • Radiopharmaceuticals