Magnetic resonance imaging of bone metastases in patients with nonseminomatous germ cell tumors

Froehner, Michael; Aikele, Peter; Beuthien-Baumann, Bettina; Kittner, Thomas; Oehlschlaeger, Sven; Wirth, Manfred P.

doi:10.1016/j.urolonc.2006.07.017

« Previous Next »Urologic Oncology: Seminars and Original Investigations
Volume 25, Issue 3 , Pages 201-206, May 2007

Magnetic resonance imaging of bone metastases in patients with nonseminomatous germ cell tumors

Michael Froehner, M.D.
- Department of Urology, University Hospital “Carl Gustav Carus,” Technical University of Dresden, Dresden, Germany
- Corresponding author. Tel.: +49-351-4582447; fax: +49-351-4584333.
Peter Aikele, M.D.
- Department of Radiology, University Hospital “Carl Gustav Carus,” Technical University of Dresden, Dresden, Germany
Bettina Beuthien-Baumann, M.D.
- Department of Nuclear Medicine and PET Center Rossendorf, University Hospital “Carl Gustav Carus,” Technical University of Dresden, Dresden, Germany
Thomas Kittner, M.D.
- Department of Radiology, University Hospital “Carl Gustav Carus,” Technical University of Dresden, Dresden, Germany
Sven Oehlschlaeger, M.D.
- Department of Urology, University Hospital “Carl Gustav Carus,” Technical University of Dresden, Dresden, Germany
Manfred P. Wirth, M.D.
- Department of Urology, University Hospital “Carl Gustav Carus,” Technical University of Dresden, Dresden, Germany

Received 2 May 2006; received in revised form 26 June 2006; accepted 14 July 2006.

Abstract

Objective

To investigate the role of magnetic resonance imaging (MRI) of bone metastases in nonseminomatous germ cell tumors.

Methods and Materials

There were 5 consecutive patients with bone metastases from nonseminomatous germ cell tumors treated between 2003 and 2006 who underwent imaging studies, including MRI. The characteristic imaging findings are discussed in the light of the clinical course.

Results

Of the 5 patients, 3 had symptoms related to bone involvement at diagnosis. All patients received conventional x-ray of their bony lesions, but only 1 of them was considered abnormal. Skeletal MRI was obtained in all patients. A bone scan was available in 3 cases with spinal involvement. It was normal in 1 case and detected only a minority of the lesions visible on MRI in the other 2 cases. Follow-up MRIs were available in all patients. A partial resolution of bone involvement during chemotherapy was observed in only 1 of them. In 2 cases, there was a slight progression of a diffuse alteration of the bone marrow during treatment. In 1 patient, severe spinal bone marrow changes were visible on MRI 2 years after cessation of treatment without evidence of disease recurrence.

Conclusions

MRI may disclose bone metastases in nonseminomatous germ cell tumors, which otherwise may be missed. MRI findings of bone lesions during treatment do not directly reflect the course of the disease and have to be interpreted with caution using clinical information.

Keywords: Magnetic resonance imaging, Germ cell tumor, Bone metastases, Bone scan, Residual masses