Soliman Moaaz, Taunk Neil K, Simons Robert E, Osborne Joseph R, Kim Michelle M, Szerlip Nicholas J, Spratt Daniel E
Departments of1Radiation Oncology and.
Departments of2Radiation Oncology and.
Neurosurg Focus. 2017 Jan;42(1):E5. doi: 10.3171/2016.9.FOCUS16350.
Spine stereotactic radiosurgery (SSRS) has recently emerged as an increasingly effective treatment for spinal metastases. Studies performed over the past decade have examined the role of imaging in the diagnosis of metastases, as well as treatment response following SSRS. In this paper, the authors describe and review the utility of several imaging modalities in the diagnosis of spinal metastases and monitoring of their response to SSRS. Specifically, we review the role of CT, MRI, and positron emission tomography (PET) in their ability to differentiate between osteoblastic and osteolytic lesions, delineation of initial bony pathology, detection of treatment-related changes in bone density and vertebral compression fracture after SSRS, and tumor response to therapy. Validated consensus guidelines defining the imaging approach to SSRS are needed to standardize the diagnosis and treatment response assessment after SSRS. Future directions of spinal imaging, including advances in targeted tumor-specific molecular imaging markers demonstrate early promise for advancing the role of imaging in SSRS.
脊柱立体定向放射外科（SSRS）最近已成为治疗脊柱转移瘤越来越有效的方法。过去十年进行的研究探讨了成像在转移瘤诊断以及SSRS治疗反应方面的作用。在本文中，作者描述并回顾了几种成像方式在脊柱转移瘤诊断及其对SSRS反应监测中的效用。具体而言，我们回顾了CT、MRI和正电子发射断层扫描（PET）在区分成骨和溶骨病变、描绘初始骨病理、检测SSRS后骨密度和椎体压缩骨折的治疗相关变化以及肿瘤对治疗的反应方面的作用。需要经过验证的共识指南来定义SSRS的成像方法，以规范SSRS后的诊断和治疗反应评估。脊柱成像的未来方向，包括靶向肿瘤特异性分子成像标志物的进展，显示出在推进成像在SSRS中的作用方面具有早期前景。
