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A 28-year-old man with non-Hodgkin’s lymphoma. a Coronal whole-body STIR imaging shows suspect areas with hyperintense signal in the right clavicular region and both iliac bones. b Magnification shows a mass extending from the right clavicular fossa and infiltrating the right apical thoracic cage. c The lesion shows a pathological FDG uptake in PET-CT, indicating malignancy. d The T1-weighted sagittal image of the spine shows extensive multifocal lymphoma manifestations. e PET-CT underestimates the degree of tumor involvement by showing tracer uptake only in the thoraco-lumbar region
Fat-suppressed sequences, such as STIR, depict neoplastic lesions
by virtue of the hyperintense signal due to increased content of
water within the tumor cells (Fig. 2 ).
78%, Figs. 1 , 2 ).
Schmidt, Gerwin P.; Reiser, Maximilian F.; Baur-Melnyk, AndreaJournal: Skeletal Radiology
Issue 12DOI: 10.1007/s00256-007-0323-5Published: 2007-10-24Institution(s):
University Hospitals Munich/Grosshadern, LMU
In clinical practice various modalities are used for whole-body imaging of the musculoskeletal system, including radiography, bone scintigraphy, computed tomography, magnetic resonance imaging (MRI), and positron emission tomography-computed tomography (PET-CT). Multislice CT is far more sensitive than radiographs in the assessment of trabecular and cortical bone destruction and allows for evaluation of fracture risk. The introduction of combined PET-CT scanners has markedly increased diagnostic accuracy for the detection of skeletal metastases compared with PET alone. The unique soft-tissue contrast of MRI enables for precise assessment of bone marrow infiltration and adjacent soft tissue structures so that alterations within the bone marrow may be detected before osseous destruction becomes apparent in CT or metabolic changes occur on bone scintigraphy or PET scan. Improvements in hard- and software, including parallel image acquisition acceleration, have made high resolution whole-body MRI clinically feasible. Whole-body MRI has successfully been applied for bone marrow screening of metastasis and systemic primary bone malignancies, like multiple myeloma. Furthermore, it has recently been proposed for the assessment of systemic bone diseases predisposing for malignancy (e.g., multiple cartilaginous exostoses) and muscle disease (e.g., muscle dystrophy). The following article gives an overview on state-of-the-art whole-body imaging of the musculoskeletal system and highlights present and potential future applications, especially in the field of whole-body MRI.
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