Pattern of Tumour Spread of Common Primary Tumours as Seen on Magnetic Resonance Imaging

Although some reports with computed tomography and bone scintigraphy are available in the literature, the distinct epidemiologic description of skeletal metastatic pattern of various tumors is still lacking. This study uses a novel approach to identify skeletal metastases from magnetic resonance imaging (MRI) data to describe metastatic pattern in common malignancies. A retrospective analysis of 130 cancer patients (42 lung, 56 breast, 11 prostate cancers; 21 multiple myeloma) with vertebral metastases and without disseminated disease, and whom underwent a whole body 3Tesla MRI investigation (Discovery MR750w), was carried out. Multiple myeloma had the most commonly disseminated metastatic disease (95%) compared to lung (28%), breast (44%) and prostate (71%) cancers. Lung cancer was related to more frequent pedicle involvement compared to breast or prostate cancer (29, 9 and 0%, p < 0.05). Pathologic fracture was mainly associated with multiple myeloma (43%). The prevalence of lung cancer metastases was more frequent in the lumbal spine (81%), as well as particular in C7, D7, D8, D9 and L1, compared to breast cancers. Most differences among tumors were detected in the extravertebral osseous metastatic pattern (p < 0.05). The highest frequency of extravertebral skeletal metastases was present in multiple myeloma (28 to 76%). Brain metastasis was more frequent in lung cancer compared to breast cancers (35% vs. 17%, p < 0.05). Significant differences in the skeletal metastatic pattern among common malignancies were demonstrated with MRI.