ACR appropriateness criteria on metastatic bone disease
Catherine C Roberts, Richard H Daffner, Barbara N Weissman, Laura Bancroft, D Lee Bennett, Judy S Blebea, Michael A Bruno, Ian Blair Fries, Isabelle M Germano, Langston Holly, Jon A Jacobson, Jonathan S Luchs, William B Morrison, Jeffrey J Olson, William K Payne, Charles S Resnik, Mark E Schweitzer, Leanne L Seeger, Mihra Taljanovic, James N Wise, Stephen T Lutz, Catherine C Roberts, Richard H Daffner, Barbara N Weissman, Laura Bancroft, D Lee Bennett, Judy S Blebea, Michael A Bruno, Ian Blair Fries, Isabelle M Germano, Langston Holly, Jon A Jacobson, Jonathan S Luchs, William B Morrison, Jeffrey J Olson, William K Payne, Charles S Resnik, Mark E Schweitzer, Leanne L Seeger, Mihra Taljanovic, James N Wise, Stephen T Lutz
Abstract
Appropriate imaging modalities for screening, staging, and surveillance of patients with suspected and documented metastatic disease to bone include (99m)Tc bone scanning, MRI, CT, radiography, and 2-[(18)F]fluoro-2-deoxyglucose-PET. Clinical scenarios reviewed include asymptomatic stage 1 breast carcinoma, symptomatic stage 2 breast carcinoma, abnormal bone scan results with breast carcinoma, pathologic fracture with known metastatic breast carcinoma, asymptomatic well-differentiated and poorly differentiated prostate carcinoma, vertebral fracture with history of malignancy, non-small-cell lung carcinoma staging, symptomatic multiple myeloma, osteosarcoma staging and surveillance, and suspected bone metastasis in a pregnant patient. No single imaging modality is consistently best for the assessment of metastatic bone disease across all tumor types and clinical situations. In some cases, no imaging is indicated. The recommendations contained herein are the result of evidence-based consensus by the ACR Appropriateness Criteria((R)) Expert Panel on Musculoskeletal Radiology.
Source: PubMed