Freedman G M, Negendank W G, Hudes G R, Shaer A H, Hanks G E
Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania 19111, USA.
Urology. 1999 Jul;54(1):118-23. doi: 10.1016/s0090-4295(99)00090-4.
To compare the accuracy of a bone marrow magnetic resonance imaging (MRI) protocol in patients at high risk of metastatic disease with radioisotopic bone scans, the standard method for detection of bony metastases in patients with prostate cancer.
The study group consisted of 19 men with prostate cancer who underwent a bone marrow MRI between November 1993 and February 1996. This protocol images the marrow of the thoracolumbar spine, sacrum, pelvis, and femurs. Indications for MRI included an equivocal bone scan and/or staging of locally advanced or recurrent disease. The findings on MRI and bone scan were compared and the results correlated with the subsequent clinical patient outcome.
The bone marrow MRI protocol detected metastatic disease in 1 (7%) of 13 patients with negative bone scans. Four patients had an indeterminate bone scan: 2 had true-positive MRIs, 1 a true-negative MRI, and 1 a false-positive MRI on the basis of subsequent clinical follow-up. Two patients with positive bone scans had true-positive MRIs.
Although not recommended for routine staging, MRI was useful in this study for clarifying an equivocal bone scan. The bone marrow MRI protocol images a high yield volume of the bony skeleton and is fast and economical compared with obtaining many focused MRI scans of these areas separately. These preliminary data suggest that further investigation of its clinical utility for staging locally advanced or recurrent disease is justified.
将骨髓磁共振成像（MRI）方案在转移性疾病高危患者中的准确性与放射性核素骨扫描进行比较，放射性核素骨扫描是检测前列腺癌患者骨转移的标准方法。
研究组由19例前列腺癌男性患者组成，他们在1993年11月至1996年2月期间接受了骨髓MRI检查。该方案对胸腰椎、骶骨、骨盆和股骨的骨髓进行成像。MRI的适应证包括骨扫描结果不明确和/或局部晚期或复发性疾病的分期。比较MRI和骨扫描的结果，并将结果与随后的临床患者结局相关联。
在13例骨扫描阴性的患者中，骨髓MRI方案检测到1例（7%）有转移性疾病。4例患者的骨扫描结果不确定：根据随后的临床随访，2例MRI结果为真阳性，1例为真阴性，1例为假阳性。2例骨扫描阳性的患者MRI结果为真阳性。
虽然不推荐用于常规分期，但在本研究中MRI有助于明确不明确的骨扫描结果。骨髓MRI方案可对大量骨骼进行成像，与分别对这些区域进行多次局部MRI扫描相比，快速且经济。这些初步数据表明，有理由进一步研究其在局部晚期或复发性疾病分期中的临床应用价值。
