Table 1 Comparison of advantages and disadvantages of various imaging modalities for the detection of BCBM
Imaging modality | Pros | Cons |
|---|---|---|
Bone ECT | Provide excellent overall assessment of the skeleton and is recommended as the preferred imaging modality for asymptomatic patients | Unable to differentiate between osteolytic and osteoblastic lesions, nor can it provide a clear indication of the extent of bone destruction |
PET-CT | Relatively higher sensitivity or specificity and offers both functional and anatomical imaging capabilities | High cost |
X-ray | Basic and commonly used imaging modality; relatively inexpensive and readily available. X-ray can accurately determine the specific location of the lesions and their relationship with the surrounding bones and joints | Low sensitivity |
CT | Suitable for complex anatomical structures and can display the size, location, and extent of bone metastases, as well as the bone destruction, repair, and calcification after treatment. It is the preferred modality for evaluating treatment efficacy | It is difficult to distinguish between focal osteoporosis and small disseminated tumors, and it has slightly lower sensitivity |
MRI | Excellent soft tissue contrast resolution and can better visualize bone marrow and adjacent soft tissues. It is radiation-free | Bone cortex appears as a dark signal in both T1 and T2-weighted sequences, making it unable to accurately reflect bone repair or damage |