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<meta name="DC.Title" content="Improved Detection of Skull Metastasis with Diffusion-Weighted MR Imaging" />
<meta name="DC.Identifier" content="10.3174/ajnr.A0501" />
<meta name="DC.Date" content="2007-06-01" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Metastasis to the skull is clinically important, but routine MR imaging offers moderate sensitivity for skull-metastasis detection in our experience. We sought to determine if diffusion-weighted MR imaging (DWI) could improve the detection of skull metastasis in patients with primary carcinomas that metastasized to bone compared with conventional MR imaging.

MATERIALS AND METHODS: Seventy-five patients from the tumor registry of our institution with extracranial primary malignancy who had brain MR imaging with DWI and radionuclide bone scanning (RNBS, gold standard) within a 6-week interval were evaluated. Thirty-eight patients demonstrated increased radiopharmaceutical uptake on RNBS, consistent with skull metastasis of any size, and the remaining 37 were control subjects. Two readers correlated the DWI and conventional MR imaging with RNBS.

RESULTS: The overall sensitivity of DWI for detection of skull metastases was 68.4%–71.1% (κ = 0.68) versus 42.1%–55.3% (κ = 0.65) for conventional MR imaging. Breast cancer ( n = 20) was detected with greatest sensitivity of 86.7%–93.3% (κ = 0.80) for DWI versus 60%–80% (κ = 0.5) for conventional MR imaging. Lung cancer ( n = 32) was detected with 63.6%–72.7% sensitivity (κ = 0.56), and prostate cancer ( n = 8) with 14.3% sensitivity (κ = 0.5) for DWI versus 27.3%–36.4% (κ = 0.81) and 14.3–42.9% (κ = 0), respectively, for conventional MR imaging.

CONCLUSIONS: DWI is a useful sequence for identifying focal skull metastases for breast and lung malignancies and, compared with conventional MR imaging, provides improved detection of these lesions. DWI is insensitive for detecting skull metastases from prostate carcinoma." />
<meta name="DC.Contributor" content="A.J. Nemeth" />
<meta name="DC.Contributor" content="J.W. Henson" />
<meta name="DC.Contributor" content="M.E. Mullins" />
<meta name="DC.Contributor" content="R.G. Gonzalez" />
<meta name="DC.Contributor" content="P.W. Schaefer" />
<meta name="article:published_time" content="2007-06-01" />
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<meta name="citation_title" content="Improved Detection of Skull Metastasis with Diffusion-Weighted MR Imaging" />
<meta name="citation_abstract" lang="en" content="&lt;p&gt;&lt;b&gt;BACKGROUND AND PURPOSE:&lt;/b&gt; Metastasis to the skull is clinically important, but routine MR imaging offers moderate sensitivity for skull-metastasis detection in our experience. We sought to determine if diffusion-weighted MR imaging (DWI) could improve the detection of skull metastasis in patients with primary carcinomas that metastasized to bone compared with conventional MR imaging.&lt;/p&gt;&lt;p&gt;&lt;b&gt;MATERIALS AND METHODS:&lt;/b&gt; Seventy-five patients from the tumor registry of our institution with extracranial primary malignancy who had brain MR imaging with DWI and radionuclide bone scanning (RNBS, gold standard) within a 6-week interval were evaluated. Thirty-eight patients demonstrated increased radiopharmaceutical uptake on RNBS, consistent with skull metastasis of any size, and the remaining 37 were control subjects. Two readers correlated the DWI and conventional MR imaging with RNBS.&lt;/p&gt;&lt;p&gt;&lt;b&gt;RESULTS:&lt;/b&gt; The overall sensitivity of DWI for detection of skull metastases was 68.4%–71.1% (κ = 0.68) versus 42.1%–55.3% (κ = 0.65) for conventional MR imaging. Breast cancer (&lt;i&gt;n&lt;/i&gt; = 20) was detected with greatest sensitivity of 86.7%–93.3% (κ = 0.80) for DWI versus 60%–80% (κ = 0.5) for conventional MR imaging. Lung cancer (&lt;i&gt;n&lt;/i&gt; = 32) was detected with 63.6%–72.7% sensitivity (κ = 0.56), and prostate cancer (&lt;i&gt;n&lt;/i&gt; = 8) with 14.3% sensitivity (κ = 0.5) for DWI versus 27.3%–36.4% (κ = 0.81) and 14.3–42.9% (κ = 0), respectively, for conventional MR imaging.&lt;/p&gt;&lt;p&gt;&lt;b&gt;CONCLUSIONS:&lt;/b&gt; DWI is a useful sequence for identifying focal skull metastases for breast and lung malignancies and, compared with conventional MR imaging, provides improved detection of these lesions. DWI is insensitive for detecting skull metastases from prostate carcinoma.&lt;/p&gt;" />
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<meta name="twitter:title" content="Improved Detection of Skull Metastasis with Diffusion-Weighted MR Imaging" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Metastasis to the skull is clinically important, but routine MR imaging offers moderate sensitivity for skull-metastasis detection in our experience. We sought to determine if diffusion-weighted MR imaging (DWI) could improve the detection of skull metastasis in patients with primary carcinomas that metastasized to bone compared with conventional MR imaging.

MATERIALS AND METHODS: Seventy-five patients from the tumor registry of our institution with extracranial primary malignancy who had brain MR imaging with DWI and radionuclide bone scanning (RNBS, gold standard) within a 6-week interval were evaluated. Thirty-eight patients demonstrated increased radiopharmaceutical uptake on RNBS, consistent with skull metastasis of any size, and the remaining 37 were control subjects. Two readers correlated the DWI and conventional MR imaging with RNBS.

RESULTS: The overall sensitivity of DWI for detection of skull metastases was 68.4%–71.1% (κ = 0.68) versus 42.1%–55.3% (κ = 0.65) for conventional MR imaging. Breast cancer ( n = 20) was detected with greatest sensitivity of 86.7%–93.3% (κ = 0.80) for DWI versus 60%–80% (κ = 0.5) for conventional MR imaging. Lung cancer ( n = 32) was detected with 63.6%–72.7% sensitivity (κ = 0.56), and prostate cancer ( n = 8) with 14.3% sensitivity (κ = 0.5) for DWI versus 27.3%–36.4% (κ = 0.81) and 14.3–42.9% (κ = 0), respectively, for conventional MR imaging.

CONCLUSIONS: DWI is a useful sequence for identifying focal skull metastases for breast and lung malignancies and, compared with conventional MR imaging, provides improved detection of these lesions. DWI is insensitive for detecting skull metastases from prostate carcinoma." />
<meta name="og-title" property="og:title" content="Improved Detection of Skull Metastasis with Diffusion-Weighted MR Imaging" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/28/6/1088" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Metastasis to the skull is clinically important, but routine MR imaging offers moderate sensitivity for skull-metastasis detection in our experience. We sought to determine if diffusion-weighted MR imaging (DWI) could improve the detection of skull metastasis in patients with primary carcinomas that metastasized to bone compared with conventional MR imaging.

MATERIALS AND METHODS: Seventy-five patients from the tumor registry of our institution with extracranial primary malignancy who had brain MR imaging with DWI and radionuclide bone scanning (RNBS, gold standard) within a 6-week interval were evaluated. Thirty-eight patients demonstrated increased radiopharmaceutical uptake on RNBS, consistent with skull metastasis of any size, and the remaining 37 were control subjects. Two readers correlated the DWI and conventional MR imaging with RNBS.

RESULTS: The overall sensitivity of DWI for detection of skull metastases was 68.4%–71.1% (κ = 0.68) versus 42.1%–55.3% (κ = 0.65) for conventional MR imaging. Breast cancer ( n = 20) was detected with greatest sensitivity of 86.7%–93.3% (κ = 0.80) for DWI versus 60%–80% (κ = 0.5) for conventional MR imaging. Lung cancer ( n = 32) was detected with 63.6%–72.7% sensitivity (κ = 0.56), and prostate cancer ( n = 8) with 14.3% sensitivity (κ = 0.5) for DWI versus 27.3%–36.4% (κ = 0.81) and 14.3–42.9% (κ = 0), respectively, for conventional MR imaging.

CONCLUSIONS: DWI is a useful sequence for identifying focal skull metastases for breast and lung malignancies and, compared with conventional MR imaging, provides improved detection of these lesions. DWI is insensitive for detecting skull metastases from prostate carcinoma." />
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      <h1 class="highwire-cite-title" id="page-title">Improved Detection of Skull Metastasis with Diffusion-Weighted MR Imaging</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">A.J. Nemeth</span>, <span class="highwire-citation-author" data-delta="1">J.W. Henson</span>, <span class="highwire-citation-author" data-delta="2">M.E. Mullins</span>, <span class="highwire-citation-author" data-delta="3">R.G. Gonzalez</span> and <span class="highwire-citation-author" data-delta="4">P.W. Schaefer</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">June 2007,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">28 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(6) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1088-1092; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A0501 </span></div>
  
  
  
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Jun 2007, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">28 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(6) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1088-1092; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A0501 </span></div>
  
  
  
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      <div class="highwire-cite-title">Improved Detection of Skull Metastasis with Diffusion-Weighted MR Imaging</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">A.J.</span> <span class="nlm-surname">Nemeth</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">J.W.</span> <span class="nlm-surname">Henson</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">M.E.</span> <span class="nlm-surname">Mullins</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">R.G.</span> <span class="nlm-surname">Gonzalez</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">P.W.</span> <span class="nlm-surname">Schaefer</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Jun 2007, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">28 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(6) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1088-1092; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A0501 </span></div>
  
  
  
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