Comparison of whole-body MR imaging with diffusion-weighted images and scintigraphy in the detection of bone metastases from postoperative breast cancer

The aim of this study was a presentation of whole-body MRI (WB-MRI) technique with diffusion-weighted imaging (DWI) as a screening tool for bone metastases in patients with breast cancer. Seventy-one patients with breast carcinoma underwent both bone scintigraphy (BS) and WB-MRI at 1.5T. The maximal longitudinal field of view was 200 cm. The total spine was imaged in the sagittal plane with a three-station approach for two image sets (fast spin-echo T1-weighted images and short tau inversion recovery images), accompanied by coronal images were acquired with a seven-station approach for two image sets (fast field echo T1-weighted images and short tau inversion recovery images). DWI was then acquired using background body suppression with b-value 600 sec/mm2. Metastatic lesions were confirmed by follow-up examination over 10 months. WB-MRI was superior to BS in predicting lesion origin with a specificity of 98.5% (scintigraphy 84.7%) and an efficiency of 98.6% (scintigraphy 85.9%). In 6 bone metastases cases, WB-MRI identified 22 lesions, while BS identified 17 lesions. WB-MRI with DWI may be an effective method of total body screening for bone in the patients with breast carcinoma. (author)