NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.
Evidence reviews for investigations – diagnosis
Spinal metastases and metastatic spinal cord compression
Evidence review F
NICE Guideline, No. 234
London: National Institute for Health and Care Excellence (NICE); 2023 Sep.
ISBN-13: 978-1-4731-5316-5
Investigations - diagnosis
Review question
How effective are radiological imaging techniques in the diagnosis of spinal metastases, direct malignant infiltration of the spine or associated spinal cord compression?
Introduction
The diagnosis of metastatic spinal cord compression or spinal metastases typically requires radiological imaging. Clinical signs may be the same for malignant and benign spinal disease in people with known primary cancer. Some people without known primary cancer present with spinal cord compression as their first symptom. MRI has been the method of choice for investigating malignant spinal disease and cord compression, due to its ability to identify metastatic disease within bone, visualise the soft tissue component of lesions and show the degree of any cord compression. Computed tomography (CT) and fluorodeoxyglucose-positron emission tomography-computed tomography (FDG-PET-CT) also potentially provide additional information. This review aimed to summarise the effectiveness of different radiological imaging techniques in the diagnosis of spinal metastases, direct malignant infiltration of the spine or associated spinal cord compression.
Summary of the protocol
See Table 1 for a summary of the Population, Index test, Reference standard (or Comparator), Target condition and Outcome (PIRTO) characteristics of this review.
Table 1
Summary of the protocol (PIRTO table).
For further details see the review protocol in appendix A.
Methods and process
This evidence review was developed using the methods and process described in Developing NICE guidelines: the manual. Methods specific to this review question are described in the review protocol in appendix A and the methods document (supplementary document 1).
Declarations of interest were recorded according to NICE’s conflicts of interest policy.
Diagnostic evidence
Included studies
Twenty studies were included in this evidence review, 1 randomised trial (Dearnaley 2022), 1 observational study (Allan 2009), 3 systematic reviews (Kim 2020, Li 2019, Suh 2018) and 15 diagnostic accuracy studies (Bacher 2021, Husband 2001, Kato 2015, Kim 2000, Laufer 2009, Maeder 2018, Perry 2018, Phadke 2001, Razek 2019, Schmeel 2018, Schmeel 2021, Shi 2017, Spinnato 2018, Taheri 2017, Zafar 2020).
Test and treat studies
One test-and-treat RCT (Dearnaley 2022) compared screening MRI with no screening MRI in men at high risk of malignant spinal cord compression.
One study (Allan 2009) compared a rapid MRI referral hotline for suspected malignant spinal cord compression with usual care.
Diagnostic test accuracy studies
One systematic review (Suh 2018) and 5 additional studies (Maeder 2018, Perry 2018, Schmeel 2021, Shi 2017, Taheri 2017) evaluated chemical shift MRI for the differential diagnosis of malignant and non-malignant bone marrow lesions.
Two systematic reviews (Li 2019, Suh 2018) and 2 additional studies (Bacher 2021, Schmeel 2018) evaluated chemical shift MRI for the differential diagnosis of malignant and non-malignant vertebral compression fractures.
One systematic review (Li 2019) and 3 additional studies (Kato 2015, Razek 2019, Zafar 2020) evaluated conventional MRI sequences, contrast enhanced MRI and diffusion weighted imaging for the differential diagnosis of malignant and non-malignant vertebral compression fractures.
One systematic review (Kim 2020) evaluated FDG-PET-CT or FDG-PET for the differential diagnosis of malignant and non-malignant vertebral compression fractures.
One study (Husband 2001) evaluated plain radiographs and neurology for the diagnosis of malignant spinal cord compression and for the impact of MRI on treatment planning.
One study (Kim 2000) reported the diagnostic accuracy of T1-weighted sagittal images alone for the for the diagnosis of malignant spinal cord compression.
Three studies (Laufer 2009, Phadke 2001, Spinnato 2018) reported the diagnostic yield of CT-guided biopsy of suspected malignant spinal lesions.
The included studies are summarised in Table 2.
See the literature search strategy in appendix B and study selection flow chart in appendix C.
Excluded studies
Studies not included in this review are listed, and reasons for their exclusion are provided in appendix K.
Summary of included studies
Summaries of the studies that were included in this review are presented in Table 2.
Table 2
Summary of included studies.
See the full evidence tables in appendix D, the forest plots in appendix E and the study data in appendix L.
Summary of the evidence
Screening MRI verses no screening MRI
Evidence from a randomised trial indicated that screening using spinal MRI for people at high risk of metastatic spinal cord compression made no important difference to overall survival. There was also no evidence of important difference in neurological and functional status, pain or quality of life. The evidence quality ranged from low to high.
MSCC hotline verses usual care
Evidence from an observational study showed a benefit of a telephone hotline compared to usual care because it enabled rapid referral and diagnosis of patients with suspected MSCC. Median time from referral to diagnosis was 2 weeks shorter in the telephone hotline group compared to usual care. Patients referred via the hotline were also more likely to be ambulant at the time of diagnosis. The evidence quality ranged from very low to low.
Chemical shift MRI for the differential diagnosis of malignant and non-malignant vertebral bone marrow lesions
Chemical shift MRI had acceptable (>80%) sensitivity and specificity in the differential diagnosis of malignant and non-malignant vertebral bone marrow lesions (BML). Likelihood ratios indicated that chemical shift MRI is a useful test in this context (positive likelihood ratio [LR+] > 5 and negative likelihood ratio [LR−] < 0.2). The evidence quality for this was moderate to high.
FDG-PET for the differential diagnosis of malignant and non-malignant vertebral compression fractures
FDG-PET or FDG-PET-CT had acceptable (>80%) sensitivity for the differential diagnosis of malignant and non-malignant VCF, but somewhat lower specificity suggesting false positives would be an issue with this imaging modality. Likelihood ratios indicated that FDG-PET or FDG-PET-CT was potentially a useful test (LR+ between 2 and 5, LR− <0.2) again indicating some uncertainty in positive test results. The evidence quality for this was low.
Chemical shift MRI for the differential diagnosis of malignant and non-malignant vertebral compression fractures
Chemical shift MRI had acceptable (>80%) sensitivity and specificity for differential diagnosis of malignant and non-malignant vertebral compression fractures (VCF). Likelihood ratios indicated that chemical shift MRI is a useful test in this context (LR+ > 5, LR− < 0.2). The evidence quality for this was moderate to high.
Conventional MRI sequences(with or without DWI) for the differential diagnosis of malignant and non-malignant vertebral compression fractures
Conventional MRI sequences with or without diffusion weighted imaging or contrast enhancement had acceptable sensitivity and specificity for differential diagnosis of VCF. Likelihood ratios indicated that conventional MRI sequences with diffusion weighted imaging is a useful test in this context (LR+ > 5, LR− < 0.2). The evidence quality for this was moderate. Likelihood ratios indicated that conventional MRI sequences are a useful test in this context (LR+ > 5, LR− < 0.2). The evidence quality for this was very low to moderate.
Tests for diagnosis of metastatic spinal cord compression
Evidence for imaging diagnosis of spinal cord compression was more limited. One study indicated that T1-weighted sagittal MRI images alone had relatively low sensitivity but high specificity for spinal cord compression. Likelihood ratios indicated this was potentially a useful test (LR+ > 5, LR− between 0.2 and 0.5). Another observational study found that plain radiographs plus neurological examination had very low sensitivity but high specificity for spinal cord compression. The likelihood ratios indicated plain radiographs plus neurological examination was unlikely to be a useful test for metastatic spinal cord compression (LR+ > 5, LR− > 0.5). The evidence quality for this was low.
Very low quality evidence suggested that CT-guided biopsies of suspected metastatic spinal lesions do not always provide sufficient material for diagnosis. There was uncertainty, however, about how often this occurs with reported diagnostic yields ranging from 81% to 99% in the included studies.
See appendix F for GRADE and modified GRADE tables.
Economic evidence
Included studies
A systematic review of the economic literature was conducted but no economic studies were identified which were applicable to this review question.
A single economic search was undertaken for all topics included in the scope of this guideline. See supplement 2 for details.
Excluded studies
Economic studies not included in this review are listed, and reasons for their exclusion are provided in supplement 2.
No economic modelling was undertaken for this review because the committee agreed that other topics were higher priorities for economic evaluation.
The committee's discussion and interpretation of the evidence
The outcomes that matter most
Critical outcomes were overall survival, disease related morbidity, neurological/functional status and quality of life. This was because prompt and accurate diagnosis should lead to appropriate treatment, avoiding the morbidity caused by spinal cord compression and potentially prolonging life. For this reason, diagnostic accuracy was also a critical outcome.
Pain was an important outcome because it is a common symptom of metastatic spinal disease with negative impact on quality of life. Time to treatment was an important outcome because diagnostic uncertainty can delay treatment. Also, referral for specialist tests or dealing with equivocal test results can cause treatment delays. False positive test results can have important consequences in this group, leading to unnecessary treatment or biopsy. Morbidity caused by biopsy was included as an important outcome for this reason. Finally test failure was included as an important outcome, because sometimes diagnostic tests do not produce a clear positive or negative result, leading to uncertainty, repeated tests and diagnostic delays.
The quality of the evidence
The quality of the evidence rated using GRADE ranged from low to high. The main issues that lowered the quality of the outcomes were risk of bias and imprecision.
No evidence was identified relating to CT scans or for the outcomes of disease-related morbidity, pain, consequences of false positives and morbidity due to biopsy.
Benefits and harms
Radiologist involvement
Based on their knowledge and experience the committee noted that carrying out radiological imagining of the spine and interpreting the results is complex (for example, selecting the correct sequencing and, if necessary, supplementary axial imaging) and that the impact of errors may have very serious consequences. In their experience there is also variation in how urgently results are reported, which can affect starting timely treatment. The committee agreed that imaging should be overseen by a radiologist. It was discussed that having a radiologist present at all MRI imaging appointments for MSCC would be difficult because of the urgency in which they would need to be conducted. They noted that it is now possible that scans can be overseen virtually which means that a radiologist would not necessarily need to be there in person but could oversee it remotely. Having a radiologist there also means that they can interpret and report the findings promptly.
The committee discussed the evidence showing an important benefit of a telephone hotline compared to usual care. They noted that it enabled rapid referral and diagnosis of patients with suspected MSCC. They agreed that any pathway to urgent MRI is useful and there are service configurations that work in some areas but not others. However, they decided not to recommend a hotline for MRI because they did not want to be prescriptive about how services organise their MRI lists to provide urgent access. They acknowledged that this is addressed in another part of the guideline that is focused on service configuration to support urgent MRI diagnosis of MSCC (see evidence review A).
MRI assessment
Based on the evidence and their experience the committee agreed that conventional MRI sequences (including T1-weighted imaging, T2-weighted imaging and short TI inversion recovery (STIR) sequences) have acceptable sensitivity and specificity (considerably higher than the committee’s decision threshold of 80%) for identifying metastatic disease within bone when the correct sequences are used, and they listed the appropriate sequences in their recommendation. Sagittal T1 and/or STIR sequences of the whole spine would be used identify spinal metastases. Whereas sagittal T2 weighted sequences (with supplementary axial imaging) can also show any soft tissue component of the mass and the degree of spinal cord compression.
The committee discussed the evidence on adding contrast-enhanced MRI, diffusion weighted imaging or chemical shift MRI to conventional sequences which may have a role in differentiating normal versus malignant bone marrow or osteoporotic versus malignant compression fractures. They were not convinced the evidence supported routinely adding these additional sequences to conventional MRI because the main role of MRI in this context is to identify the presence or absence of metastases and involvement of the spinal cord, rather than differentiate benign verses malignant lesions or fractures, however they understood that these additional sequences may be useful in selected cases and that local protocols or guidelines would be typically in place for their use.
They recommended not to perform routine MRI in people without symptoms or signs of cord compression in order to screen for MSCC, because evidence from a randomised trial did not demonstrate any benefit of surveillance MRIs in people who are asymptomatic but are at high risk of MSCC.
Other imaging techniques for diagnosis and management
Although there was no evidence about the use of CT in diagnosis of metastatic spinal disease the committee acknowledged that MRI might be contraindicated in some people (for instance anyone with metal implants). They considered CT was an appropriate alternative (although less sensitive than modern MRI) for imaging the spine in these cases and widely used for cancer staging. They acknowledged, based on experience that in rare cases there may be an indication for CT myelography, but this would need to be done in a specialist centre because it is an invasive procedure which is associated with some risks.
The committee discussed that many patients presenting with symptoms of spinal metastases or cord compression may have already had plain X-rays as initial investigations, but they agreed based on their experience that plain X-rays were not as sensitive for detecting metastatic bone disease as MRI and recommended they should not be used to diagnose or rule out spinal metastases, direct malignant infiltration (DMI) of the spine or MSCC. There was also evidence that X-rays and neurological examination would detect less than half of the cases of spinal cord compression which can accompany spinal metastases.
The committee noted the evidence showing that CT-guided biopsies of suspected metastatic spinal lesions do not always provide sufficient material for diagnosis. However, they decided that due to the very low quality there was too much uncertainty about this evidence to base a recommendation on.
Cost effectiveness and resource use
No economic evidence was identified for this topic from the systematic search of previously published evidence. The committee considered cost effectiveness based on their own experience and knowledge.
Recommendations for this topic will lead to cost savings with no or limited impact on outcomes for people receiving these healthcare services. Whilst imaging being overseen by a radiologist would take up their time and associated costs the consequences of missing important details would be serious which would accrue larger costs in the long term. Recommendations against routine MRI in people without symptoms or signs of MSCC should reduce the number of MRIs undertaken although only a handful of centres are currently performing MRI in these circumstances. RCT evidence suggests this will have no impact upon outcomes or quality of life for patients.
Recommendations against x-ray, although a less expensive imaging technique should reduce costs as the diagnostic utility of them is very limited and MRI diagnostic imaging would always have to be carried out to get sufficiently detailed information to locate the tumour and plan treatment.
Recommendations supported by this evidence review
This evidence review supports recommendations 1.5.1 and 1.5.5 to 1.5.9 in the NICE guideline.
References – included studies
Allan 2009
Allan L, Baker L, Dewar J, et al Suspected malignant cord compression – Improving time to diagnosis via a hotline: A prospective audit. British Journal of Cancer, 100, 1867–1872, 2009 [PMC free article: PMC2714247] [PubMed: 19471276]Bacher 2021
Bacher S, Hajdu S, Maeder Y, et al Differentiation between benign and malignant vertebral compression fractures using qualitative and quantitative analysis of a single fast spin echo T2-weighted Dixon sequence. European Radiology, 31, 9418–942, 2021 [PMC free article: PMC8589814] [PubMed: 34041569]Dearnaley 2022
Dearnaley D, Hinder V, Hijab A, et al Observation versus screening spinal MRI and pre-emptive treatment for spinal cord compression in patients with castration-resistant prostate cancer and spinal metastases in the UK (PROMPTS): an open-label, randomised, controlled, phase 3 trial. Lancet: Oncology, 23, 501–513, 2022 [PMC free article: PMC8960282] [PubMed: 35279270]Husband 2001
Husband D, Grant K, Romaniuk C. MRI in the diagnosis and treatment of suspected malignant spinal cord compression. British Journal of Radiology 74, 15–23, 2001 [PubMed: 11227772]Kato 2015
Kato S, Hozumi T, Yamakawa K, et al META: an MRI-based scoring system differentiating metastatic from osteoporotic vertebral fractures. Spine Journal, 15, 1563–70, 2015 [PubMed: 25777741]Kim 2000
Kim J, Learch T, Colletti P, et al Diagnosis of vertebral metastasis, epidural metastasis, and malignant spinal cord compression: are T(1)-weighted sagittal images sufficient? Magnetic Resonance Imaging 18, 819–24, 2000 [PubMed: 11027875]Kim 2020
Kim S, Lee J. (2020) Diagnostic performance of F-18 FDG PET or PET/CT for differentiation of benign from malignant vertebral compression fractures; A meta-analysis. World Neurosurgery, 137: e626–e633, 2020 [PubMed: 32105873]Laufer 2009
Laufer I, Lis E, Pisinski L, et al The accuracy of [(18) F] fluorodeoxyglucose positron emission tomography as confirmed by biopsy in the diagnosis of spine metastases in a cancer population. Neurosurgery, 64, 107–4, 2009 [PubMed: 19145159]Li 2019
Li K, Huang L, Lang Z, et al Reliability and Validity of Different MRI Sequences in Improving the Accuracy of Differential Diagnosis of Benign and Malignant Vertebral Fractures: A Meta-Analysis. American Journal of Roentgenology, 213, 427–436, 2019 [PubMed: 31039028]Maeder 2018
Maeder Y, Dunet V, Richard R, et al Bone Marrow Metastases: T2-weighted Dixon Spin-Echo Fat Images Can Replace T1-weighted Spin-Echo Images. Radiology, 286, 948–959, 2018 [PubMed: 29095674]Perry 2018
Perry M, and Sebro R. Accuracy of Opposed-phase Magnetic Resonance Imaging for the Evaluation of Treated and Untreated Spinal Metastases. Academic Radiology, 25, 877–882, 2018 [PubMed: 29398437]Phadke 2001
Phadke D, Lucas D, Madan S. Fine-needle aspiration biopsy of vertebral and intervertebral disc lesions: specimen adequacy, diagnostic utility, and pitfalls. Archives of Pathology and Laboratory Medicine, 125, 1463–8, 2001 [PubMed: 11698003]Razek 2009
Razek A, Sherif F. Diagnostic accuracy of diffusion tensor imaging in differentiating malignant from benign compressed vertebrae. Neuroradiology, 61, 1291–1296, 2019 [PubMed: 31492969]Schmeel 2018
Schmeel F, Luetkens J, Feist A, et al Quantitative evaluation of T2* relaxation times for the differentiation of acute benign and malignant vertebral body fractures. European Journal of Radiology, 108, 59–65, 2018 [PubMed: 30396672]Schmeel 2021
Schmeel F, Enkirch S, Luetkens J, et al Diagnostic Accuracy of Quantitative Imaging Biomarkers in the Differentiation of Benign and Malignant Vertebral Lesions: Combination of Diffusion-Weighted and Proton Density Fat Fraction Spine MRI. Clinical Neuroradiology, 31, 1059–1070, 2021 [PMC free article: PMC8648653] [PubMed: 33787957]Shi 2017
Shi Y, Li X, Zhang X, et al Differential diagnosis of hemangiomas from spinal osteolytic metastases using 3.0 T MRI: comparison of T1-weighted imaging, chemical-shift imaging, diffusion-weighted and contrast-enhanced imaging. Oncotarget, 8, 71095–71104, 2017 [PMC free article: PMC5642620] [PubMed: 29050345]Spinnato 2018
Spinnato P, Bazzocchi A, Facchini G, et al Vertebral Fractures of Unknown Origin: Role of Computed Tomography-Guided Biopsy. International Journal of Spine Surgery, 12, 673–679, 2018 [PMC free article: PMC6314342] [PubMed: 30619670]Suh 2018
Suh C, Yun S, Jin W, et al Diagnostic Performance of In-Phase and Opposed-Phase Chemical-Shift Imaging for Differentiating Benign and Malignant Vertebral Marrow Lesions: A Meta-Analysis. American Journal of Roentgenology 211, W1–W10, 2018 [PubMed: 30160981]Taheri 2017
Taheri M, Mirzaei H, Shahhamzei S, et al Comparison of chemical shift MR imaging findings between vertebral benign and metastatic lesions. International Journal of Cancer Management 10, e8661, 2017Zafar 2020
Zafar U, Malik A, Shahzad I, et al Diagnostic accuracy of qualitative diffusion weighted MRI of spine in differentiating between benign and malignant vertebral fractures taking histopathology as gold standard. Pakistan Journal of Medical and Health Sciences 14, 390–392, 2020
Diagnostic
Appendices
Appendix A. Review protocols
Appendix B. Search strategy (clinical/economic)
Appendix C. Effectiveness evidence study selection
Appendix D. Evidence tables
Appendix E. Forest plots
Appendix F. GRADE and modified GRADE tables
Appendix G. Economic evidence study selection
Study selection for: How effective are radiological imaging techniques in the diagnosis of spinal metastases, direct malignant infiltration of the spine or associated spinal cord compression?
No economic evidence was identified which was applicable to this review question.
Appendix H. Economic evidence tables
Economic evidence tables for review question: How effective are radiological imaging techniques in the diagnosis of spinal metastases, direct malignant infiltration of the spine or associated spinal cord compression?
No evidence was identified which was applicable to this review question.
Appendix I. Economic model
Economic model for review question: How effective are radiological imaging techniques in the diagnosis of spinal metastases, direct malignant infiltration of the spine or associated spinal cord compression?
No economic analysis was conducted for this review question.
Appendix J. Excluded studies
Excluded studies for review question: How effective are radiological imaging techniques in the diagnosis of spinal metastases, direct malignant infiltration of the spine or associated spinal cord compression?
Excluded diagnostic studies
Table 10Excluded studies and reasons for their exclusion
| Study | Exclusion reason |
|---|---|
| Abdel-Wanis, M E; Solyman, Mohamed Tharwat Mahmoud; Hasan, Nahla Mohamed Ali (2011) Sensitivity, specificity and accuracy of magnetic resonance imaging for differentiating vertebral compression fractures caused by malignancy, osteoporosis, and infections. Journal of orthopaedic surgery (Hong Kong) 19(2): 145–50 [PubMed: 21857034] | Outcomes do not match review protocol |
| Abdullayev, N, Grose Hokamp, N, Lennartz, S et al (2019) Improvements of diagnostic accuracy and visualization of vertebral metastasis using multi-level virtual non-calcium reconstructions from dual-layer spectral detector computed tomography. European radiology 29(11): 5941–5949 [PubMed: 31041562] | Index test - does not match review protocol |
| Abedi, S.M.; Mardanshahi, A.; Zeanali, R. (2021) Added diagnostic value of SPECT to evaluate bone metastases in breast cancer patients with normal whole body bone scan. Caspian Journal of Internal Medicine 12(3): 290–293 [PMC free article: PMC8223046] [PubMed: 34221278] | Population - does not match review protocol |
| Abikhzer, G., Srour, S., Fried, G. et al (2016) Prospective comparison of whole-body bone SPECT and sodium 18F-fluoride PET in the detection of bone metastases from breast cancer. Nuclear Medicine Communications 37(11): 1160–1168 [PubMed: 27536906] | Population - does not match review protocol |
| Abrahm, J.L. (2004) Assessment and treatment of patients with malignant spinal cord compression. Journal of Supportive Oncology 2(5): 377–391 [PubMed: 15524067] | Study design - does not match review protocol |
| Adamova, Blanka, Bednarik, Josef, Andrasinova, Tereza et al (2015) Does lumbar spinal stenosis increase the risk of spondylotic cervical spinal cord compression? 24(12): 2946–53 [PubMed: 26038157] | Population - does not match review protocol |
| Adams, S, Baum, R P, Stuckensen, T et al (1998) Prospective comparison of 18F-FDG PET with conventional imaging modalities (CT, MRI, US) in lymph node staging of head and neck cancer. European journal of nuclear medicine 25(9): 1255–60 [PubMed: 9724374] | Population - does not match review protocol |
| Adogwa, Owoicho, Rubio, Daniel R, Buchowski, Jacob M et al (2022) Spine-specific skeletal related events and mortality in non-small cell lung cancer patients: a single-institution analysis. Journal of neurosurgery. Spine 36(1): 125–132 [PubMed: 33254136] | Index test - does not match review protocol |
| Aggarwal, Ashish, Salunke, Pravin, Shekhar, Bala Raja et al (2013) The role of magnetic resonance imaging and positron emission tomography-computed tomography combined in differentiating benign from malignant lesions contributing to vertebral compression fractures. Surgical neurology international 4(suppl5): 323–6 [PMC free article: PMC3717528] [PubMed: 23878766] | Other protocol criteria - study reported in an included systematic review (Kim 2020) |
| Ahn, Ji Eun, Lee, Jeong Hyun, Yi, Jong Sook et al (2008) Diagnostic accuracy of CT and ultrasonography for evaluating metastatic cervical lymph nodes in patients with thyroid cancer. World journal of surgery 32(7): 1552–8 [PubMed: 18408961] | Population - does not match review protocol |
| Algra, P R, Bloem, J L, Tissing, H et al (1991) Detection of vertebral metastases: comparison between MR imaging and bone scintigraphy. Radiographics: a review publication of the Radiological Society of North America, Inc 11(2): 219–32 [PubMed: 2028061] | Outcomes - do not match review protocol |
| Alkalay, Ron N, Groff, Michael W, Stadelmann, Marc A et al (2022) Improved estimates of strength and stiffness in pathologic vertebrae with bone metastases using CT-derived bone density compared with radiographic bone lesion quality classification. Journal of neurosurgery. Spine 36(1): 113–124 [PMC free article: PMC9210826] [PubMed: 34479191] | Population - does not match review protocol |
| Altehoefer, C, Ghanem, N, Hogerle, S et al (2001) Comparative detectability of bone metastases and impact on therapy of magnetic resonance imaging and bone scintigraphy in patients with breast cancer. European journal of radiology 40(1): 16–23 [PubMed: 11673003] | Population - does not match review protocol |
| Ambrosini, Valentina, Nanni, Cristina, Zompatori, Maurizio et al (2010) (68)Ga-DOTA-NOC PET/CT in comparison with CT for the detection of bone metastasis in patients with neuroendocrine tumours. European journal of nuclear medicine and molecular imaging 37(4): 722–7 [PubMed: 20107793] | Population - does not match review protocol |
| An, H S, Vaccaro, A R, Dolinskas, C A et al (1991) Differentiation between spinal tumors and infections with magnetic resonance imaging. Spine 16(8suppl): 334–8 [PubMed: 1785083] | Other protocol criteria - study reported in an included systematic review (Thawait 2012) |
| Anatol’Evich Byvaltsev, V.; Stepanov, I.A.; Kichigin, A.I. (2019) The role of diffusion-weighted MRI of patients with spine metastases. Coluna/Columna 18(4): 289–293 | Outcomes – do not match review protocol |
| Andreasson, I, Petren-Mallmin, M, Strang, P et al (1990) Diagnostic methods in planning palliation of spinal metastases. Anticancer research 10(3): 731–3 [PubMed: 1695079] | Outcomes - do not match review protocol |
| Anonymous. (2022) Correction to Lancet Oncol 2022; 23: 501–13 (The Lancet Oncology (2022) 23(4) (501–513), (S1470204522000924), (10.1016/S1470-2045(22)00092-4)). The Lancet Oncology 23(4): e161 [CrossRef] | Study design - does not match review protocol |
| Arevalo-Perez, Julio, Peck, Kyung K, Lyo, John K et al (2015) Differentiating benign from malignant vertebral fractures using T1 -weighted dynamic contrast-enhanced MRI. Journal of magnetic resonance imaging : JMRI 42(4): 1039–47 [PMC free article: PMC5525155] [PubMed: 25656545] | Other protocol criteria - study reported in an included systematic review (Li 2019) |
| Asa, Sertac, Sonmezoglu, Kerim, Uslu-Besli, Lebriz et al (2021) Evaluation of F-18 DOPA PET/CT in the detection of recurrent or metastatic medullary thyroid carcinoma: comparison with GA-68 DOTA-TATE PET/CT. Annals of nuclear medicine 35(8): 900–915 [PubMed: 33993425] | Population - does not match review protocol |
| Asilturk, Murad; Abdallah, Anas; Sofuoglu, Erhan Ozden (2020) Radiologic-Histopathologic Correlation of Adult Spinal Tumors: A Retrospective Study. Asian journal of neurosurgery 15(2): 354–362 [PMC free article: PMC7335153] [PubMed: 32656132] | Population - does not match review protocol |
| Baker, L L, Goodman, S B, Perkash, I et al (1990) Benign versus pathologic compression fractures of vertebral bodies: assessment with conventional spin-echo, chemical-shift, and STIR MR imaging. Radiology 174(2): 495–502 [PubMed: 2296658] | Other protocol criteria - study reported in an included systematic review (Thawait 2012) |
| Baleriaux, D; Matos, C; De Greef, D (1993) Gadodiamide injection as a contrast medium for MRI of the central nervous system: a comparison with gadolinium-DOTA. Neuroradiology 35(7): 490–4 [PubMed: 8232870] | Comparator - does not match review protocol |
| Balliu, E, Vilanova, J C, Pelaez, I et al (2009) Diagnostic value of apparent diffusion coefficients to differentiate benign from malignant vertebral bone marrow lesions. European journal of radiology 69(3): 560–6 [PubMed: 18276098] | Other protocol criteria - study reported in an included systematic review (Thawait 2012) |
| Balogova, Sona, Zakoun, Joseph Ben, Michaud, Laure et al (2014) Whole-body 18F-fluorocholine (FCH) PET/CT and MRI of the spine for monitoring patients with castration-resistant prostate cancer metastatic to bone: a pilot study. Clinical nuclear medicine 39(11): 951–9 [PubMed: 25140552] | Outcomes - do not match review protocol |
| Baur, A, Huber, A, Ertl-Wagner, B et al (2001) Diagnostic value of increased diffusion weighting of a steady-state free precession sequence for differentiating acute benign osteoporotic fractures from pathologic vertebral compression fractures. AJNR. American journal of neuroradiology 22(2): 366–72 [PMC free article: PMC7973927] [PubMed: 11156785] | Other protocol criteria - study reported in an included systematic review (Thawait 2012) |
| Baur, A, Stabler, A, Bruning, R et al (1998) Diffusion-weighted MR imaging of bone marrow: differentiation of benign versus pathologic compression fractures. Radiology 207(2): 349–56 [PubMed: 9577479] | Other protocol criteria - study reported in an included systematic review (Thawait 2012) |
| Baur, Andrea, Stabler, Axel, Arbogast, Susanne et al (2002) Acute osteoporotic and neoplastic vertebral compression fractures: fluid sign at MR imaging. Radiology 225(3): 730–5 [PubMed: 12461253] | Other protocol criteria - study reported in an included systematic review |
| Bazzocchi, Alberto, Spinnato, Paolo, Garzillo, Giorgio et al (2012) Detection of incidental vertebral fractures in breast imaging: the potential role of MR localisers. European radiology 22(12): 2617–23 [PubMed: 22688128] | Population – does not match protocol |
| Beeler, Whitney H, Paradis, Kelly C, Gemmete, Joseph J et al (2019) Computed Tomography Myelosimulation Versus Magnetic Resonance Imaging Registration to Delineate the Spinal Cord During Spine Stereotactic Radiosurgery. World neurosurgery 122: e655–e666 [PubMed: 30992117] | Index test – does not match protocol |
| Bhugaloo, Aa, Abdullah, Bjj, Siow, Ys et al (2006) Diffusion weighted MR imaging in acute vertebral compression fractures: differentiation between malignant and benign causes. Biomedical imaging and intervention journal 2(2): e12 [PMC free article: PMC3097619] [PubMed: 21614224] | Other protocol criteria - study reported in an included systematic review (Liu 2019) |
| Bierry, Guillaume, Venkatasamy, Aina, Kremer, Stephane et al (2014) Dual-energy CT in vertebral compression fractures: performance of visual and quantitative analysis for bone marrow edema demonstration with comparison to MRI. Skeletal radiology 43(4): 485–92 [PubMed: 24445957] | Population – does not match protocol |
| Boesen, J, Johnsen, A, Helweg-Larsen, S et al (1991) Diagnostic value of spinal computer tomography in patients with intraspinal metastases causing complete block on myelography. Acta radiologica (Stockholm, Sweden : 1987) 32(1): 1–2 [PubMed: 2012721] | Outcomes – do not match protocol |
| Bohdiewicz, Paul J, Wong, Ching-Yee O, Kondas, David et al (2003) High predictive value of F-18 FDG PET patterns of the spine for metastases or benign lesions with good agreement between readers. Clinical nuclear medicine 28(12): 966–70 [PubMed: 14663317] | Outcomes – do not match protocol |
| Bohuslavizki, K.H., Klutmann, S., Buchert, R. et al (1999) Value of F-18-FOG PET in patients with cervical lymph node metastases of unknown origin. Radiology and Oncology 33(3): 207–213 | Population – does not match protocol |
| Boker, Sarah M, Adams, Lisa C, Bender, Yvonne Y et al (2019) Differentiation of Predominantly Osteoblastic and Osteolytic Spine Metastases by Using Susceptibility-weighted MRI. Radiology 290(1): 146–154 [PubMed: 30375926] | Comparator – does not match protocol |
| Boogerd, W. and Kroger, R. (1991) Intravenous contrast in spinal computed tomography to identify epidural metastases. Clinical Neurology and Neurosurgery 93(3): 195–199 [PubMed: 1660371] | Outcomes – do not match protocol |
| Boogerd, W; van der Sande, J J; Kroger, R (1992) Early diagnosis and treatment of spinal epidural metastasis in breast cancer: a prospective study. Journal of neurology, neurosurgery, and psychiatry 55(12): 1188–93 [PMC free article: PMC1015337] [PubMed: 1479399] | Outcomes – do not match protocol |
| Borggrefe, Jan, Neuhaus, Victor-Frederic, Le Blanc, Markus et al (2019) Accuracy of iodine density thresholds for the separation of vertebral bone metastases from healthy-appearing trabecular bone in spectral detector computed tomography. European radiology 29(6): 3253–3261 [PubMed: 30523450] | Index test – does not match protocol |
| Bredella, Miriam A, Essary, Brendan, Torriani, Martin et al (2008) Use of FDG-PET in differentiating benign from malignant compression fractures. Skeletal radiology 37(5): 405–13 [PMC free article: PMC2271083] [PubMed: 18278491] | Other protocol criteria - study reported in an included systematic review (Kim 2020) |
| Brunner, P., Chanalet, S., Sedat, J. et al (2002) Percutaneous infiltrations of cervical, thoracic, and lumbar spine. Seminars in Interventional Radiology 19(3): 219–228 | Intervention – does not match protocol |
| Buhmann Kirchhoff, Sonja, Becker, Christoph, Duerr, Hans Roland et al (2009) Detection of osseous metastases of the spine: comparison of high resolution multi-detector-CT with MRI. European journal of radiology 69(3): 567–73 [PubMed: 18191356] | Population – does not match protocol - unclear how patients were identified for the study |
| Burns, Joseph E, Yao, Jianhua, Wiese, Tatjana S et al (2013) Automated detection of sclerotic metastases in the thoracolumbar spine at CT. Radiology 268(1): 69–78 [PMC free article: PMC3689444] [PubMed: 23449957] | Population – does not match protocol - case control design |
| Buyukdereli, Gulgun, Ermin, Tahsin, Kara, Oguz et al (2006) Tc-99m MIBI uptake in traumatic vertebral fractures and metastatic vertebral lesions: comparison with Tc-99m MDP. Advances in therapy 23(1): 33–8 [PubMed: 16644620] | Outcomes – do not match protocol |
| Byun, Woo Mok, Jang, Han Won, Kim, Sang Woo et al (2007) Diffusion-weighted magnetic resonance imaging of sacral insufficiency fractures: comparison with metastases of the sacrum. Spine 32(26): e820–4 [PubMed: 18091477] | Outcomes – do not match protocol |
| Byun, Woo Mok, Shin, Sei One, Chang, Yongmin et al (2002) Diffusion-weighted MR imaging of metastatic disease of the spine: assessment of response to therapy. AJNR. American journal of neuroradiology 23(6): 906–12 [PMC free article: PMC7976927] [PubMed: 12063214] | Population – does not match protocol |
| Castillo, M, Arbelaez, A, Smith, J K et al (2000) Diffusion-weighted MR imaging offers no advantage over routine noncontrast MR imaging in the detection of vertebral metastases. AJNR. American journal of neuroradiology 21(5): 948–53 [PMC free article: PMC7976774] [PubMed: 10815675] | Population – does not match protocol |
| Castroneves, LA, Coura Filho, G, de Freitas, RMC et al (2018) Comparison of 68Ga PET/CT to Other Imaging Studies in Medullary Thyroid Cancer: Superiority in Detecting Bone Metastases. The Journal of clinical endocrinology and metabolism 103(9): 3250–3259 [PubMed: 29846642] | Population – does not match protocol |
| Chabot, M.C. and Herkowitz, H.N. (1995) Spine tumors: Patient evaluation. Seminars in Spine Surgery 7(4): 260–268 | Study design – does not match protocol |
| Chadwick, D.J., Gingell, J.C., Gillatt, D.A. et al (1991) Magnetic resonance imaging of spinal metastases. Journal of the Royal Society of Medicine 84(4): 196–200 [PMC free article: PMC1293180] [PubMed: 2027142] | Outcomes – does not match protocol |
| Chan, J H M, Peh, W C G, Tsui, E Y K et al (2002) Acute vertebral body compression fractures: discrimination between benign and malignant causes using apparent diffusion coefficients. The British journal of radiology 75(891): 207–14 [PubMed: 11932212] | Other protocol criteria - study reported in an included systematic review (Thawait 2012) |
| Chan, Jimmy Yu Wai, Chan, Richie Chiu Lung, Chow, Velda Ling Yu et al (2013) Efficacy of fine-needle aspiration in diagnosing cervical nodal metastasis from nasopharyngeal carcinoma after radiotherapy. The Laryngoscope 123(1): 134–9 [PubMed: 22907783] | Population – does not match protocol |
| Chen, C J and Hsu, W C (1997) Imaging findings of spontaneous spinal epidural hematoma. Journal of the Formosan Medical Association = Taiwan yi zhi 96(4): 283–7 [PubMed: 9136517] | Population – does not match protocol |
| Chen, Hongliang, Xie, Biao, Zhong, Xin et al (2021) Magnetic Resonance Image under Variable Model Algorithm in Diagnosis of Patients with Spinal Metastatic Tumors. Contrast media & molecular imaging 2021:1381274 [PMC free article: PMC8384545] [PubMed: 34483780] | Comparator – does not match protocol |
| Chen, Y, Zhang, E, Wang, Q et al (2021) Use of dynamic contrast-enhanced MRI for the early assessment of outcome of CyberKnife stereotactic radiosurgery for patients with spinal metastases. Clinical radiology 76(11): 864e1–864e6 [PubMed: 34404514] | Outcomes – do not match protocol |
| Chiewvit, Pipat, Danchaivijitr, Nasuda, Sirivitmaitrie, Kaewta et al (2009) Does magnetic resonance imaging give value-added than bone scintigraphy in the detection of vertebral metastasis?. Journal of the Medical Association of Thailand = Chotmaihet thangphaet 92(6): 818–29 [PubMed: 19530588] | Population – does not match protocol |
| Cho, Se Jin, Suh, Chong Hyun, Baek, Jung Hwan et al (2019) Diagnostic performance of CT in detection of metastatic cervical lymph nodes in patients with thyroid cancer: a systematic review and meta-analysis. European radiology 29(9): 4635–4647 [PubMed: 30806803] | Population – does not match protocol |
| Cho, Won-Ik and Chang, Ung-Kyu (2011) Comparison of MR imaging and FDG-PET/CT in the differential diagnosis of benign and malignant vertebral compression fractures. Journal of neurosurgery. Spine 14(2): 177–83 [PubMed: 21214309] | Other protocol criteria - study reported in an included systematic review (Kim 2020) |
| Ciray, I, Lindman, H, Astrom, K G et al (2001) Early response of breast cancer bone metastases to chemotherapy evaluated with MR imaging. Acta radiologica (Stockholm, Sweden : 1987) 42(2): 198–206 [PubMed: 11259949] | Population – does not match protocol |
| Colletti, P M, Dang, H T, Deseran, M W et al (1991) Spinal MR imaging in suspected metastases: correlation with skeletal scintigraphy. Magnetic resonance imaging 9(3): 349–55 [PubMed: 1881253] | Outcomes – do not match protocol |
| Colletti, P M, Siegel, H J, Woo, M Y et al (1996) The impact on treatment planning of MRI of the spine in patients suspected of vertebral metastasis: an efficacy study. Computerized medical imaging and graphics : the official journal of the Computerized Medical Imaging Society 20(3): 159–62 [PubMed: 8930468] | Outcomes – do not match protocol |
| Cook, A M, Lau, T N, Tomlinson, M J et al (1998) Magnetic resonance imaging of the whole spine in suspected malignant spinal cord compression: impact on management. Clinical oncology (Royal College of Radiologists (Great Britain)) 10(1): 39–43 [PubMed: 9543614] | Outcomes – do not match protocol |
| Cox, M., Pukenas, B., Poplawski, M. et al (2016) CT-guided Cervical Bone Biopsy in 43 Patients: Diagnostic Yield and Safety at Two Large Tertiary Care Hospitals. Academic Radiology 23(11): 1372–1375 [PubMed: 27555546] | Outcomes – do not match protocol |
| Cuenod, C A, Laredo, J D, Chevret, S et al (1996) Acute vertebral collapse due to osteoporosis or malignancy: appearance on unenhanced and gadolinium-enhanced MR images. Radiology 199(2): 541–9 [PubMed: 8668809] | Other protocol criteria - study reported in an included systematic review (Thawait 2012) |
| Dandekar, M R, Kannan, S, Rangarajan, V et al (2011) Utility of PET in unknown primary with cervical metastasis: a retrospective study. Indian journal of cancer 48(2): 181–6 [PubMed: 21768663] | Population – does not match protocol |
| De Bruin, H.G., Algra, P.R., Kruyt, R.H. et al (1999) Comparison of the FISP 2D sequence with spin echo T1 weighted images before and after intravenous Gd-chelates in detection and evaluation of spinal metastases. Image Decisions MRI 3(4): 10–15 | Other protocol criteria – not available in English |
| Delpassand, E S, Garcia, J R, Bhadkamkar, V et al (1995) Value of SPECT imaging of the thoracolumbar spine in cancer patients. Clinical nuclear medicine 20(12): 1047–51 [PubMed: 8674287] | Outcomes – do not match protocol |
| Demirdogen, Ezgi, Ursavas, Ahmet, Aydin Guclu, Ozge et al (2020) Diagnostic performance of EBUS-TBNA and its interrelation with PET-CT in patients with extra-thoracic malignancies. Tuberkuloz ve toraks 68(3): 285–292 [PubMed: 33295727] | Intervention – does not match protocol |
| Donners, R., Hirschmann, A., Gutzeit, A. et al (2021) T2-weighted Dixon MRI of the spine: A feasibility study of quantitative vertebral bone marrow analysis. Diagnostic and Interventional Imaging 102(78): 431–438 [PubMed: 33612414] | Population – does not match protocol |
| Douis, H, Davies, A M, Jeys, L et al (2016) Chemical shift MRI can aid in the diagnosis of indeterminate skeletal lesions of the spine. European radiology 26(4): 932–40 [PubMed: 26162578] | Other protocol criteria - study reported in an included systematic review (Suh 2018) |
| Eissawy, M.G., Saadawy, A.M.I., Farag, K. et al (2021) Accuracy and diagnostic value of diffusion-weighted whole body imaging with background body signal suppression (DWIBS) in metastatic breast cancer. Egyptian Journal of Radiology and Nuclear Medicine 52(1): 74 | Population – does not match protocol |
| Facon, David, Ozanne, Augustin, Fillard, Pierre et al (2005) MR diffusion tensor imaging and fiber tracking in spinal cord compression. AJNR. American journal of neuroradiology 26(6): 1587–94 [PMC free article: PMC8149058] [PubMed: 15956535] | Outcomes – do not match protocol |
| Faiella, E., Santucci, D., Calabrese, A. et al (2022) Artificial Intelligence in Bone Metastases: An MRI and CT Imaging Review. International Journal of Environmental Research and Public Health 19(3): 1880 [PMC free article: PMC8834956] [PubMed: 35162902] | Population – does not match protocol |
| Fan, Xiaojie, Zhang, Xiaoyu, Zhang, Zibo et al (2021) Deep Learning on MRI Images for Diagnosis of Lung Cancer Spinal Bone Metastasis. Contrast media & molecular imaging 2021: 5294379 [PMC free article: PMC8294999] [PubMed: 34354553] | Other protocol criteria - study reported in an included systematic review (Faiella 2022) |
| Fan, Xin, Zhang, Han, Yin, Yuzhen et al (2020) Texture Analysis of 18F-FDG PET/CT for Differential Diagnosis Spinal Metastases. Frontiers in medicine 7: 605746 [PMC free article: PMC7843930] [PubMed: 33521018] | Intervention – does not match protocol |
| Feroz, Imza, Makhdoomi, Rumana Hamid, Khursheed, Nayil et al (2018) Utility of Computed Tomography-guided Biopsy in Evaluation of Metastatic Spinal Lesions. Asian journal of neurosurgery 13(3): 577–584 [PMC free article: PMC6159094] [PubMed: 30283508] | Outcomes – do not match protocol |
| Filograna, Laura, Lenkowicz, Jacopo, Cellini, Francesco et al (2019) Identification of the most significant magnetic resonance imaging (MRI) radiomic features in oncological patients with vertebral bone marrow metastatic disease: a feasibility study. La Radiologia medica 124(1): 50–57 [PubMed: 30191445] | Other protocol criteria - study reported in an included systematic review (Faiella 2022) |
| Frank, J A, Ling, A, Patronas, N J et al (1990) Detection of malignant bone tumors: MR imaging vs scintigraphy. AJR. American journal of roentgenology 155(5): 1043–8 [PubMed: 2120933] | Population – does not match protocol |
| Freire, A.R.S., Lima, E.N.P., Almeida, O.P. et al (2003) Computed tomography and lymphoscintigraphy to identify lymph node metastases and lymphatic drainage pathways in oral and oropharyngeal squamous cell carcinomas. European Archives of Oto-Rhino-Laryngology 260(3): 148–152 [PubMed: 12687387] | Population – does not match protocol |
| Fu, Tsai-Sheng, Chen, Li-Hui, Liao, Jen-Chung et al (2004) Magnetic resonance imaging characteristics of benign and malignant vertebral fractures. Chang Gung medical journal 27(11): 808–15 [PubMed: 15796256] | Other protocol criteria - study reported in an included systematic review (Thawait 2012) |
| Gabriel, Michael, Decristoforo, Clemens, Donnemiller, Eveline et al (2003) An intrapatient comparison of 99mTc-EDDA/HYNIC-TOC with 111In-DTPA-octreotide for diagnosis of somatostatin receptor-expressing tumors. Journal of nuclear medicine 44(5): 708–16 [PubMed: 12732671] | Population – does not match protocol |
| Gao, Y, Fang, J, Liu, X et al (2006) [Diagnostic value of nuclide bone imaging for bone metastasis from lung cancer and clinic analysis]. Zhongguo fei ai za zhi = Chinese journal of lung cancer 9(4): 357–61 [PubMed: 21176456] | Population – does not match protocol |
| Gauthe, Mathieu, Testart Dardel, Nathalie, Ruiz Santiago, Fernando et al (2018) Vertebral metastases from neuroendocrine tumours: How to avoid false positives on 68Ga-DOTA-TOC PET using CT pattern analysis?. European radiology 28(9): 3943–3952 [PubMed: 29532242] | Population – does not match protocol |
| Geith, Tobias, Biffar, Andreas, Schmidt, Gerwin et al (2015) Physiological Background of Differences in Quantitative Diffusion-Weighted Magnetic Resonance Imaging Between Acute Malignant and Benign Vertebral Body Fractures: Correlation of Apparent Diffusion Coefficient With Quantitative Perfusion Magnetic Resonance Imaging Using the 2-Compartment Exchange Model. Journal of computer assisted tomography 39(5): 643–8 [PubMed: 26248148] | Outcomes – do not match protocol |
| Geith, Tobias, Biffar, Andreas, Schmidt, Gerwin et al (2013) Quantitative analysis of acute benign and malignant vertebral body fractures using dynamic contrast-enhanced MRI. AJR. American journal of roentgenology 200(6): w635–43 [PubMed: 23701095] | Other protocol criteria - study reported in an included systematic review (Li 2019) |
| Geith, Tobias, Schmidt, Gerwin, Biffar, Andreas et al (2014) Quantitative evaluation of benign and malignant vertebral fractures with diffusion-weighted MRI: what is the optimum combination of b values for ADC-based lesion differentiation with the single-shot turbo spin-echo sequence?. American journal of roentgenology 203(3): 582–8 [PubMed: 25148160] | Other protocol criteria - study reported in an included systematic review (Li 2019) |
| Geneidi, E.A.S.; Ali, H.I.; Dola, E.F. (2016) Role of DWI in characterization of bone tumors. Egyptian Journal of Radiology and Nuclear Medicine 47(3): 919–927 | Population – does not match protocol |
| Ghanem, Nadir Alexander, Pache, Gregor, Lohrmann, Christian et al (2007) MRI and (18)FDG-PET in the assessment of bone marrow infiltration of the spine in cancer patients. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 16(11): 1907–12 [PMC free article: PMC2223344] [PubMed: 17404763] | Outcomes – do not match protocol |
| Gosfield, E 3rd; Alavi, A; Kneeland, B (1993) Comparison of radionuclide bone scans and magnetic resonance imaging in detecting spinal metastases. Journal of nuclear medicine : official publication, Society of Nuclear Medicine 34(12): 2191–8 [PubMed: 8254410] | Population – does not match protocol |
| Gravel, Guillaume, Tselikas, Lambros, Moulin, Benjamin et al (2019) Early detection with MRI of incomplete treatment of spine metastases after percutaneous cryoablation. European radiology 29(10): 5655–5663 [PubMed: 30877460] | Outcomes – do not match protocol |
| Gross, N.D., Weissman, J.L., Talbot, J.M. et al (2001) MRI detection of cervical metastasis from differentiated thyroid carcinoma. Laryngoscope 111(11i): 1905–1909 [PubMed: 11801967] | Population – does not match protocol |
| Gualdi, GF, Casciani, E, Di Biasi, C et al (1999) [The role of TC and MRI in the identification, characterization and staging of tumors of the spinal vertebrae]. La Clinica terapeutica 150(1): 51–65 [PubMed: 10367545] | Other protocol criteria – not available in English |
| Guan, Youxin, Peck, Kyung K, Lyo, John et al (2020) T1-weighted Dynamic Contrast-enhanced MRI to Differentiate Nonneoplastic and Malignant Vertebral Body Lesions in the Spine. Radiology 297(2): 382–389 [PMC free article: PMC7643814] [PubMed: 32870135] | Population – does not match protocol |
| Guo, Marissa, Kolberg, Kristen L, Smith, Eleanor C et al (2018) Predominance of Spinal Metastases Involving the Posterior Vertebral Body. World neurosurgery 119: e991–e996 [PubMed: 30114534] | Outcomes – do not match protocol |
| Guo, Shuai, Chen, Jie, Yang, Baohui et al (2016) Establishment and evaluation of a prognostic model for surgical outcomes of patients with atlanto-axial dislocations. The Journal of international medical research 44(6): 1474–1482 [PMC free article: PMC5536767] [PubMed: 28322106] | Population – does not match protocol |
| Gupta, A., Chaturvedi, S., Jha, D. et al (2019) Revisiting metastatic central nervous system tumors with unknown primary using clinicopathological findings: A single neurosciences institutional study. Indian Journal of Pathology and Microbiology 62(3): 368–374 [PubMed: 31361222] | Intervention – does not match protocol |
| Ha, Ji Y, Jeon, Kyung N, Bae, Kyungsoo et al (2017) Effect of Bone Reading CT software on radiologist performance in detecting bone metastases from breast cancer. The British journal of radiology 90(1072): 20160809 [PMC free article: PMC5605069] [PubMed: 28256905] | Population – does not match protocol |
| Hahn, Seok; Lee, Young Han; Suh, Jin-Suck (2018) Detection of vertebral metastases: a comparison between the modified Dixon turbo spin echo T2 weighted MRI and conventional T1 weighted MRI: a preliminary study in a tertiary centre. The British journal of radiology 91 (1085): 20170782 [PMC free article: PMC6190773] [PubMed: 29393668] | Population – does not match protocol |
| Hammon, Matthias, Dankerl, Peter, Tsymbal, Alexey et al (2013) Automatic detection of lytic and blastic thoracolumbar spine metastases on computed tomography. European radiology 23(7): 1862–70 [PMC free article: PMC3674341] [PubMed: 23397381] | Intervention – does not match protocol |
| Han, L J, Au-Yong, T K, Tong, W C et al (1998) Comparison of bone single-photon emission tomography and planar imaging in the detection of vertebral metastases in patients with back pain. European journal of nuclear medicine 25(6): 635–8 [PubMed: 9618579] | Population – does not match protocol |
| Hao, S P and Ng, S H (2000) Magnetic resonance imaging versus clinical palpation in evaluating cervical metastasis from head and neck cancer. Otolaryngology--head and neck surgery, 123(3): 324–7 [PubMed: 10964315] | Population – does not match protocol |
| Harrison, S K; Ditchfield, M R; Waters, K (1998) Correlation of MRI and CSF cytology in the diagnosis of medulloblastoma spinal metastases. Pediatric radiology 28(8): 571–4 [PubMed: 9716623] | Population – does not match protocol - medulloblastoma |
| Henschke, Nicholas, Maher, Christopher G, Ostelo, Raymond W J G et al (2013) Red flags to screen for malignancy in patients with low-back pain. The Cochrane database of systematic reviews: cd008686 [PMC free article: PMC10631455] [PubMed: 23450586] | Intervention – does not match protocol - no imaging tests evaluated |
| Hoogcarspel, Stan J, Van der Velden, Joanne M, Lagendijk, Jan J W et al (2014) The feasibility of utilizing pseudo CT-data for online MRI based treatment plan adaptation for a stereotactic radiotherapy treatment of spinal bone metastases. Physics in medicine and biology 59(23): 7383–91 [PubMed: 25386792] | Outcomes – do not match protocol |
| Horakova, M., Horak, T., Valosek, J. et al (2022) Semi-automated detection of cervical spinal cord compression with the Spinal Cord Toolbox. Quantitative Imaging in Medicine and Surgery 12(4): 2261–2279 [PMC free article: PMC8923862] [PubMed: 35371944] | Population – does not match protocol |
| Hoshiai, Sodai, Masumoto, Tomohiko, Hanaoka, Shouhei et al (2019) Clinical usefulness of temporal subtraction CT in detecting vertebral bone metastases. European journal of radiology 118: 175–180 [PubMed: 31439238] | Population – does not match protocol |
| Hsu, H.-C., Liao, T.-Y., Ro, L.-S. et al (2019) Differences in Pain Intensity of Tumors Spread to the Anterior versus Anterolateral/Lateral Portions of the Vertebral Body Based on CT Scans. Pain Research and Management 2019: 9387941 [PMC free article: PMC6535837] [PubMed: 31214273] | Outcomes – do not match protocol |
| Huang, C W C, Ali, A, Chang, Y-M et al (2020) Major Radiologic and Clinical Outcomes of Total Spine MRI Performed in the Emergency Department at a Major Academic Medical Center. AJNR. American journal of neuroradiology 41(6): 1120–1125 [PMC free article: PMC7342750] [PubMed: 32439645] | Population – does not match protocol |
| Huang, T.-W., Chao, P.-C., Ou, J.-J. et al (2006) Cervical spine metastases secondary to colorectal carcinoma: The role of MR imaging and treatment strategy. Journal of Medical Sciences 26(6): 215–218 | Outcomes – do not match protocol |
| Iagaru, A., Young, P., Mittra, E. et al (2013) Pilot prospective evaluation of 99mTc-MDP scintigraphy, 18F NaF PET/CT, 18F FDG PET/CT and whole-body MRI for detection of skeletal metastases. Clinical Nuclear Medicine 38(7): e290–e296 [PubMed: 23455520] | Population – does not match protocol |
| Ichimaru, K., Endo, K., Ito, K. et al (1995) Spinal cord tumours: Diagnosis with myelogram of MRI?. Journal of Orthopaedic Surgery 3(2): 35–39 | Population – does not match protocol |
| Jacobson, A F, Cronin, E B, Stomper, P C et al (1990) Bone scans with one or two new abnormalities in cancer patients with no known metastases: frequency and serial scintigraphic behavior of benign and malignant lesions. Radiology 175(1): 229–32 [PubMed: 2315486] | Population – does not match protocol |
| Kakitsubata, Yousuke, Theodorou, Daphne J, Theodorou, Stavroula J et al (2009) Metastatic disease involving the discovertebral junction of the spine. Joint bone spine 76(1): 50–6 [PubMed: 18977681] | Population – does not match protocol - cadaveric study |
| Karchevsky, Michael; Babb, James S; Schweitzer, Mark E (2008) Can diffusion-weighted imaging be used to differentiate benign from pathologic fractures? A meta-analysis. Skeletal radiology 37(9): 791–5 [PubMed: 18551290] | Outcomes – do not match protocol – does not report data relevant to diagnostic accuracy |
| Kaufman, B A; Moran, C J; Park, T S (1995) Spinal magnetic resonance imaging immediately after craniotomy for detection of metastatic disease. Pediatric neurosurgery 23(4): 171–81 [PubMed: 8835206] | Population – does not match protocol |
| Kelly, Hillary R and Curtin, Hugh D (2017) Chapter 2 Squamous Cell Carcinoma of the Head and Neck-Imaging Evaluation of Regional Lymph Nodes and Implications for Management. Seminars in ultrasound, CT, and MR 38(5): 466–478 [PubMed: 29031364] | Population – does not match protocol |
| Kerslake, R W; Jaspan, T; Worthington, B S (1991) Magnetic resonance imaging of spinal trauma. The British journal of radiology 64(761): 386–402 [PubMed: 2036560] | Population – does not match protocol |
| Khan, A., Gao, A., Hall, E. et al (2017) Do Routine Computed Tomography Scans Detect Early Spinal Cord Compression in Patients with Castrate Resistant Prostate Cancer? Implications for the PROMPTS Trial. Clinical Oncology 29(3): e87–e87 | Publication type – does not match protocol |
| Kim, D.W., Kim, S.C., Krynyckyi, B.R. et al (2005) Focally increased activity in the lateral aspect of the mid cervical spine on bone scintigraphy is almost always benign in nature. Clinical Nuclear Medicine 30(9): 593–595 [PubMed: 16100474] | Outcomes – do not match protocol |
| Kim, Seong-Jang and Lee, Jung Sub (2020) Diagnostic Performance of F-18 Fluorodeoxyglucose Positron Emission Tomography or Positron Emission Tomography/Computed Tomography for Differentiation of Benign and Malignant Vertebral Compression Fractures: A Meta-Analysis. World neurosurgery 137: e626–e633 [PubMed: 32105873] | Other protocol criteria – duplicate publication |
| Kizilay, F., Sahin, M., Simsir, A. et al (2020) Predictive value of bone scintigraphy in the diagnosis of prostate cancer bone metastases and comparison of verification methods. Kuwait Medical Journal 52(4): 368–374 | Population – does not match protocol |
| Kosuda, S, Kaji, T, Yokoyama, H et al (1996) Does bone SPECT actually have lower sensitivity for detecting vertebral metastasis than MRI?. Journal of nuclear medicine, 37(6): 975–8 [PubMed: 8683325] | Outcomes – do not match protocol |
| Krabbe, Christiaan A, van der Werff-Regelink, Gerreke, Pruim, Jan et al (2010) Detection of cervical metastases with (11)C-tyrosine PET in patients with squamous cell carcinoma of the oral cavity or oropharynx: A comparison with (18)F-FDG PET. Head & neck 32(3): 368–74 [PubMed: 19626632] | Population – does not match protocol |
| Kubota, Takao, Yamada, Kei, Ito, Hirotoshi et al (2005) High-resolution imaging of the spine using multidetector-row computed tomography: differentiation between benign and malignant vertebral compression fractures. Journal of computer assisted tomography 29(5): 712–9 [PubMed: 16163049] | Outcomes – do not match protocol |
| Lang, Ning, Su, Min-Ying, Yu, Hon J et al (2013) Differentiation of myeloma and metastatic cancer in the spine using dynamic contrast-enhanced MRI. Magnetic resonance imaging 31(8): 1285–91 [PMC free article: PMC3620894] [PubMed: 23290477] | Reference standard – does not match protocol |
| Lauenstein, T.C., Freudenberg, L.S., Goehde, S.C. et al (2002) Whole-body MRI using a rolling table platform for the detection of bone metastases. European Radiology 12(8): 2091–2099 [PubMed: 12136329] | Index test – does not match protocol |
| Lee, Eugene, Lee, Joon Woo, Lee, Jinyoung et al (2016) Acute benign vertebral compression fractures: “see-through sign” on contrast-enhanced MR images. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 25(11): 3470–3477 [PubMed: 26538157] | Outcomes – do not match protocol |
| Li, X F, Yang, Y, Lin, C B et al (2016) Assessment of the diagnostic value of diffusion tensor imaging in patients with spinal cord compression: a meta-analysis. Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas 49(1): e4769 [PMC free article: PMC4681415] [PubMed: 26628393] | Outcomes – do not match protocol |
| Libshitz, H I, Malthouse, S R, Cunningham, D et al (1992) Multiple myeloma: appearance at MR imaging. Radiology 182(3): 833–7 [PubMed: 1535904] | Population – does not match protocol |
| Lin, Fan; Lei, Yi; Li, Yang-bin (2009) Influence of lesion ratio on diagnostic performance of in-phase/opposed-phase imaging and apparent diffusion coefficient for differentiating acute benign vertebral fractures and metastases. Chinese medical journal 122(11): 1293–9 [PubMed: 19567140] | Other protocol criteria - study reported in an included systematic review (Suh 2018) |
| Liu, H., Jiao, M., Yuan, Y. et al (2022) Benign and malignant diagnosis of spinal tumors based on deep learning and weighted fusion framework on MRI. Insights into Imaging 13(1): 87 [PMC free article: PMC9091071] [PubMed: 35536493] | Comparator – does not match protocol |
| Liu, J., Guo, W., Zeng, P. et al (2022) Vertebral MRI-based radiomics model to differentiate multiple myeloma from metastases: influence of features number on logistic regression model performance. European Radiology 32(1): 572–581 [PubMed: 34255157] | Comparator – does not match protocol |
| Liu, Peng, Liang, Yun, Bian, Chong et al (2020) Diagnostic accuracy of MR, CT, and ECT in the differentiation of neoplastic from nonneoplastic spine lesions. Asia-Pacific journal of clinical oncology 16(5): e192-e197 [PubMed: 32506805] | Population – does not match protocol |
| Liu, Tao, Wang, Shenghao, Liu, Hao et al (2017) Detection of vertebral metastases: a meta-analysis comparing MRI, CT, PET, BS and BS with SPECT. Journal of cancer research and clinical oncology 143(3): 457–465 [PubMed: 27752772] | Systematic review - included studies were assessed for relevance |
| Luboldt, W, Küfer, R, Blumstein, N et al (2008) Prostate carcinoma: diffusion-weighted imaging as potential alternative to conventional MR and 11C-choline PET/CT for detection of bone metastases. Radiology 249(3): 1017–25 [PubMed: 18849502] | Outcomes – do not match protocol |
| Luo, Zhanpeng, Litao, Li, Gu, Suxi et al (2016) Standard-b-value vs low-b-value DWI for differentiation of benign and malignant vertebral fractures: a meta-analysis. The British journal of radiology 89(1058): 20150384 [PMC free article: PMC4985191] [PubMed: 26612466] | Outcomes – does not match protocol |
| Lv, Mu, Zhou, Zhichao, Tang, Qingkun et al (2020) Differentiation of usual vertebral compression fractures using CT histogram analysis as quantitative biomarkers: A proof-of-principle study. European journal of radiology 131: 109264 [PubMed: 32920220] | Intervention – does not match protocol |
| Maeda, Masayuki, Sakuma, Hajime, Maier, Stephan E et al (2003) Quantitative assessment of diffusion abnormalities in benign and malignant vertebral compression fractures by line scan diffusion-weighted imaging. AJR. American journal of roentgenology 181(5): 1203–9 [PubMed: 14573404] | Other protocol criteria - study reported in an included systematic review (Thawait 2012) |
| Mahnken, Andreas H, Wildberger, Joachim E, Adam, Gerhard et al (2005) Is there a need for contrast-enhanced T1-weighted MRI of the spine after inconspicuous short tau inversion recovery imaging?. European radiology 15(7): 1387–92 [PubMed: 15776239] | Outcomes – do not match protocol |
| Maralani, P.J., Lo, S.S., Redmond, K. et al (2017) Spinal metastases: multimodality imaging in diagnosis and stereotactic body radiation therapy planning. Future Oncology 13(1): 77–91 [PubMed: 27523190] | Study design – does not match protocol |
| Matsumoto, Yoshihiro, Harimaya, Katsumi, Kawaguchi, Kenichi et al (2016) Dumbbell Scoring System: A New Method for the Differential Diagnosis of Malignant and Benign Spinal Dumbbell Tumors. Spine 41(20): e1230–e1236 [PubMed: 27031767] | Population – does not match protocol |
| McKinley, W O, Conti-Wyneken, A R, Vokac, C W et al (1996) Rehabilitative functional outcome of patients with neoplastic spinal cord compressions. Archives of physical medicine and rehabilitation 77(9): 892–5 [PubMed: 8822680] | Intervention – does not match protocol |
| Meena, Rajesh, Aggarwal, Ashish, Bhattacharya, Anish et al (2019) Non traumatic vertebral lesions: incremental utility of PET-CT over MRI and FNAC in a suggested diagnostic algorithm. British journal of neurosurgery 33(1): 25–29 [PubMed: 28282998] | Population – does not match protocol |
| Mehta, R C, Marks, M P, Hinks, R S et al (1995) MR evaluation of vertebral metastases: T1-weighted, short-inversion-time inversion recovery, fast spin-echo, and inversion-recovery fast spin-echo sequences. AJNR. American journal of neuroradiology 16(2): 281–8 [PMC free article: PMC8338328] [PubMed: 7726074] | Outcomes – do not match protocol |
| Metin, M., Ergin, M., Solak, O. et al (2012) Effectiveness of PET scan in postoperative long term follow up of patients with nonsmall cell lung cancer. Journal of Clinical and Analytical Medicine 3(1): 30–32 | Population – does not match protocol |
| Metser, Ur, Lerman, Hedva, Blank, Annat et al (2004) Malignant involvement of the spine: assessment by 18F-FDG PET/CT. Journal of nuclear medicine, 45(2): 279–84 [PubMed: 14960648] | Population – does not match protocol |
| Mihoubi Bouvier, Fadila, Thomas De Montpreville, Vincent, Besse, Benjamin et al (2021) Can MRI differentiate surrounding vertebral invasion from reactive inflammatory changes in superior sulcus tumor?. European radiology 31(12): 8991–8999 [PubMed: 33991225] | Population – does not match protocol |
| Mohson, K.I.; Naief, Q.T.; Jalil, F.A. (2020) Differentiating benign from suspicious vertebral marrow lesions detected with conventional magnetic resonance imaging using apparent diffusion coefficient and diffusion-weighted image. Open Access Macedonian Journal of Medical Sciences 8(b): 114–118 | Outcomes – do not match protocol |
| Mossa-Basha, M., Gerszten, P.C., Myrehaug, S. et al (2019) Spinal metastasis: Diagnosis, management and followup. British Journal of Radiology 92(1103): 20190211 [PMC free article: PMC6849675] [PubMed: 31322920] | Study design – does not match protocol |
| Mostardi, P M, Diehn, F E, Rykken, J B et al (2014) Intramedullary spinal cord metastases: visibility on PET and correlation with MRI features. AJNR. American journal of neuroradiology 35(1): 196–201 [PMC free article: PMC7966499] [PubMed: 23886743] | Outcomes – do not match protocol |
| Mubarak, Fatima and Akhtar, Waseem (2011) Acute vertebral compression fracture: differentiation of malignant and benign causes by diffusion weighted magnetic resonance imaging. JPMA. The Journal of the Pakistan Medical Association 61(6): 555–8 [PubMed: 22204209] | Other protocol criteria - study reported in an included systematic review (Li 2019) |
| Nakanishi, K, Kobayashi, M, Nakaguchi, K et al (2007) Whole-body MRI for detecting metastatic bone tumor: diagnostic value of diffusion-weighted images. Magnetic resonance in medical sciences, 6(3): 147–55 [PubMed: 18037795] | Population – does not match protocol |
| Narin, Y., Urhan, M., Canpolat, N. et al (2007) Lesion detectability and clinical effectiveness of dual-head coincidence gamma camera imaging in comparison with dedicated PET systems in tumour patients. Journal of International Medical Research 35(4): 467–473 [PubMed: 17697523] | Population – does not match protocol |
| Nozaki, T, Yasuda, K, Akashi, T et al (2008) Usefulness of single photon emission computed tomography imaging in the detection of lumbar vertebral metastases from prostate cancer. International journal of urology : official journal of the Japanese Urological Association 15(6): 516–9 [PubMed: 18422581] | Population – does not match protocol |
| Ohlmann-Knafo, S, Tarnoki, A D, Tarnoki, D L et al (2015) MR Diagnosis of Bone Metastases at 1.5 T and 3 T: Can STIR Imaging Be Omitted?. RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin 187(10): 924–32 [PubMed: 26085176] | Population – does not match protocol |
| Ohno, Seiichiro, Togami, Izumi, Sei, Tetsuro et al (2003) MR imaging of vertebral metastases at 0.2 Tesla: clinical evaluation of T1-weighted opposed-phase gradient-echo imaging. Physiological chemistry and physics and medical NMR 35(2): 145–56 [PubMed: 15552725] | Other protocol criteria - study reported in an included systematic review (Suh 2018) |
| Otake, S, Matsuo, M, Tamaki, T et al (1991) [Fast MR imaging of liver metastasis using FLASH and FISP--optimal sequences for T1- and T2*-weighted images]. Nihon Igaku Hoshasen Gakkai zasshi. Nippon acta radiologica 51(1): 19–32 [PubMed: 2011477] | Population – does not match protocol |
| Oztekin, Ozgur, Ozan, Ebru, Hilal Adibelli, Zehra et al (2009) SSH-EPI diffusion-weighted MR imaging of the spine with low b values: is it useful in differentiating malignant metastatic tumor infiltration from benign fracture edema?. Skeletal radiology 38(7): 651–8 [PubMed: 19252906] | Other protocol criteria - study reported in an included systematic review (Li 2019) |
| Park, Chankue, Lee, Joon Woo, Kim, Yongju et al (2019) Diagnosis of spinal metastasis: are MR images without contrast medium application sufficient?. Clinical imaging 55: 165–173 [PubMed: 30904626] | Publication type – does not match protocol |
| Park, Hee Jin, Lee, So Yeon, Rho, Myung Ho et al (2016) Single-Shot Echo-Planar Diffusion-Weighted MR Imaging at 3T and 1.5T for Differentiation of Benign Vertebral Fracture Edema and Tumor Infiltration. Korean journal of radiology 17(5): 590–7 [PMC free article: PMC5007386] [PubMed: 27587948] | Population – does not match protocol |
| Park, Sang-Min, Park, Jae-Woo, Lee, Hui-Jong et al (2017) Diagnostic Value of Technetium-99m Bone Scintigraphy in the Detection of Cervical Spine Metastases in Oncological Patients. Spine 42(22): 1699–1705 [PubMed: 28368988] | Population – does not match protocol |
| Park, Sun-Won, Lee, Joo-Hyuk, Ehara, Shigeru et al (2004) Single shot fast spin echo diffusion-weighted MR imaging of the spine; Is it useful in differentiating malignant metastatic tumor infiltration from benign fracture edema?. Clinical imaging 28(2): 102–8 [PubMed: 15050221] | Other protocol criteria - study reported in an included systematic review (Li 2019) |
| Park, Sunghoon, Yoon, Joon-Kee, Chung, Nam-Su et al (2018) Correlations between intravoxel incoherent motion diffusion-weighted MR imaging parameters and 18F-FDG PET/CT metabolic parameters in patients with vertebral bone metastases: initial experience. The British journal of radiology 91(1086): 20170889 [PMC free article: PMC6223291] [PubMed: 29509489] | Outcomes – do not match protocol |
| Perrin-Resche, I, Bizais, Y, Buhe, T et al (1993) How does iliac crest bone marrow biopsy compare with imaging in the detection of bone metastases in small cell lung cancer?. European journal of nuclear medicine 20(5): 420–5 [PubMed: 8390936] | Population – does not match protocol |
| Petren-Mallmin, M (1994) Clinical and experimental imaging of breast cancer metastases in the spine. Acta radiologica. Supplementum 391: 1–23 [PubMed: 8172006] | Outcomes – do not match protocol |
| Petren-Mallmin, M, Nordstrom, B, Andreasson, I et al (1992) MR imaging with histopathological correlation in vertebral metastases of breast cancer. Acta radiologica (Stockholm, Sweden : 1987) 33(3): 213–20 [PubMed: 1591122] | Outcomes – do not match protocol |
| Pongpornsup, Sopa; Wajanawichakorn, Phromphiang; Danchaivijitr, Nasuda (2009) Benign versus malignant compression fracture: a diagnostic accuracy of magnetic resonance imaging. Journal of the Medical Association of Thailand = Chotmaihet thangphaet 92(1): 64–72 [PubMed: 19260246] | Other protocol criteria - study reported in an included systematic review (Li 2019) |
| Poulsen, Mads H, Petersen, Henrik, Hoilund-Carlsen, Poul F et al (2014) Spine metastases in prostate cancer: comparison of technetium-99m-MDP whole-body bone scintigraphy, [(18) F]choline positron emission tomography(PET)/computed tomography (CT) and [(18) F]NaF PET/CT. BJU international 114(6): 818–23 [PubMed: 24314065] | Population – does not match protocol |
| Pozzi, G, Garcia Parra, C, Stradiotti, P et al (2012) Diffusion-weighted MR imaging in differentiation between osteoporotic and neoplastic vertebral fractures. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 21suppl1: 123–7 [PMC free article: PMC3325396] [PubMed: 22411038] | Other protocol criteria - study reported in an included systematic review (Li 2019) |
| Pozzi, Grazia, Albano, Domenico, Messina, Carmelo et al (2018) Solid bone tumors of the spine: Diagnostic performance of apparent diffusion coefficient measured using diffusion-weighted MRI using histology as a reference standard. Journal of magnetic resonance imaging, 47(4): 1034–1042 [PubMed: 28755383] | Population – does not match protocol |
| Prabhu, Vikram C, Bilsky, Mark H, Jambhekar, Kedar et al (2003) Results of preoperative embolization for metastatic spinal neoplasms. Journal of neurosurgery 98(2suppl): 156–64 [PubMed: 12650400] | Intervention – does not match protocol |
| Qi, Na, Meng, Qingyuan, You, Zhiwen et al (2021) Standardized uptake values of 99mTc-MDP in normal vertebrae assessed using quantitative SPECT/CT for differentiation diagnosis of benign and malignant bone lesions. BMC medical imaging 21(1): 39 [PMC free article: PMC7913396] [PubMed: 33639883] | Outcomes – do not match protocol |
| Qin, Feng, Feng, Yapei, Zhang, Panpan et al (2022) Diagnostic Value of Emission Computed Tomography Combined with Computed Tomography for Metastatic Malignant Tumor of Spine. Contrast media & molecular imaging 2022: 5847589 [PMC free article: PMC9162862] [PubMed: 35685665] | Index test does not match protocol |
| Reginelli, Alfonso, Silvestro, Giustino, Fontanella, Giovanni et al (2016) Performance status versus anatomical recovery in metastatic disease: The role of palliative radiation treatment. International journal of surgery (London, England) 33suppl1: 126–31 [PubMed: 27353845] | Intervention – does not match protocol |
| Ren, Hong; Lin, Wei; Ding, Xianjun (2017) Surface Coil Intensity Correction in Magnetic Resonance Imaging in Spinal Metastases. Open medicine (Warsaw, Poland) 12: 138–143 [PMC free article: PMC5471916] [PubMed: 28730173] | Index test - does not match protocol |
| Runge, V.M., Bradley, W.G., Brant-Zawadzki, M.N. et al (1991) Clinical safety and efficacy of gadoteridol: A study in 411 patients with suspected intracranial and spinal disease. Radiology 181(3): 701–709 [PubMed: 1947085] | Intervention – does not match protocol |
| Saidha, N K, Ganguly, M, Sidhu, Harkirat Singh et al (2013) The Role of 18 FDG PET-CT in Evaluation of Unknown Primary Tumours. Indian journal of surgical oncology 4(3): 236–41 [PMC free article: PMC3771057] [PubMed: 24426729] | Population – does not match protocol |
| Savelli, G., Chiti, A., Grasselli, G. et al (2000) The role of bone SPET study in diagnosis of single vertebral metastases. Anticancer Research 20(2b): 1115–1120 [PubMed: 10810405] | Population – does not match protocol |
| Scarabino, T, Giannatempo, GM, Popolizio, T et al (1996) Fast spin echo imaging of vertebral metastasis: comparison of fat suppression techniques (FSE-CHESS, STIR-FSE). Radiologia medica 92(3): 180–185 [PubMed: 8975299] | Other protocol criteria – not available in English |
| Schiff, D and O’Neill, B P (1996) Intramedullary spinal cord metastases: clinical features and treatment outcome. Neurology 47(4): 906–12 [PubMed: 8857717] | Outcomes – do not match protocol |
| Schirrmeister, H, Guhlmann, A, Elsner, K et al (1999) Sensitivity in detecting osseous lesions depends on anatomic localization: planar bone scintigraphy versus 18F PET. Journal of nuclear medicine : official publication, Society of Nuclear Medicine 40(10): 1623–9 [PubMed: 10520701] | Population – does not match protocol |
| Schmidt, GP, Baur, A, Stäbler, A et al (2005) Estimation of diffuse bone marrow infiltration of the spine in multiple myeloma: correlation of MRT with histological results. RoFo 177(5): 745–750 [PubMed: 15871089] | Other protocol criteria – not available in English |
| Sedonja, I and Budihna, N V (1999) The benefit of SPECT when added to planar scintigraphy in patients with bone metastases in the spine. Clinical nuclear medicine 24(6): 407–13 [PubMed: 10361935] | Outcomes – do not match protocol |
| Semirgin, S.U. (2019) SPECT/CT findings of suspicious vertebral metastasis on planar bone scintigraphy. Journal of Experimental and Clinical Medicine (Turkey) 36(4): 99–103 | Outcomes – do not match protocol |
| Shah, Lubdha M and Salzman, Karen L (2011) Imaging of spinal metastatic disease. International journal of surgical oncology 2011: 769753 [PMC free article: PMC3263660] [PubMed: 22312523] | Study design – does not match protocol |
| Sharma, Punit, Dhull, Varun Singh, Reddy, Rama Mohan et al (2013) Hybrid SPECT-CT for characterizing isolated vertebral lesions observed by bone scintigraphy: comparison with planar scintigraphy, SPECT, and CT. Diagnostic and interventional radiology (Ankara, Turkey) 19(1): 33–40 [PubMed: 22865157] | Index test – does not match protocol |
| Simsek, D.H., Sanli, Y., Civan, C. et al (2020) Does bone scintigraphy still have a role in the era of 68 Ga-PSMA PET/CT in prostate cancer?. Annals of Nuclear Medicine 34(7): 476–485 [PubMed: 32394269] | Population – does not match protocol |
| Sugimura, K, Kajitani, A, Okizuka, H et al (1991) Assessing response to therapy of spinal metastases with gadolinium-enhanced MR imaging. Journal of magnetic resonance imaging : JMRI 1(4): 481–4 [PubMed: 1665094] | Population – does not match protocol |
| Sung, Jin Kyeong, Jee, Won-Hee, Jung, Joon-Yong et al (2014) Differentiation of acute osteoporotic and malignant compression fractures of the spine: use of additive qualitative and quantitative axial diffusion-weighted MR imaging to conventional MR imaging at 3.0 T. Radiology 271(2): 488–98 [PubMed: 24484060] | Other protocol criteria - study reported in an included systematic review (Suh 2018) |
| Tabotta, Flavian, Jreige, Mario, Schaefer, Niklaus et al (2019) Quantitative bone SPECT/CT: high specificity for identification of prostate cancer bone metastases. BMC musculoskeletal disorders 20(1): 619 [PMC free article: PMC6933900] [PubMed: 31878904] | Population – does not match protocol |
| Tadros, M.Y. and Louka, A.L. (2016) Discrimination between benign and malignant in vertebral marrow lesions with diffusion weighted MRI and chemical shift. Egyptian Journal of Radiology and Nuclear Medicine 47(2): 557–569 | Other protocol criteria - study reported in an included systematic review (Suh 2018) |
| Tan, D Y L; Tsou, I Y Y; Chee, T S G (2002) Differentiation of malignant vertebral collapse from osteoporotic and other benign causes using magnetic resonance imaging. Annals of the Academy of Medicine, Singapore 31(1): 8–14 [PubMed: 11885502] | Other protocol criteria - study reported in an included systematic review (Thawait 2012) |
| Tan, Hui, Xu, Hui, Luo, Feifei et al (2019) Combined intravoxel incoherent motion diffusion-weighted MR imaging and magnetic resonance spectroscopy in differentiation between osteoporotic and metastatic vertebral compression fractures. Journal of orthopaedic surgery and research 14(1): 299 [PMC free article: PMC6727483] [PubMed: 31488174] | Index test – does not match protocol |
| Tang, Guangyu, Liu, Yong, Li, Wei et al (2007) Optimization of b value in diffusion-weighted MRI for the differential diagnosis of benign and malignant vertebral fractures. Skeletal radiology 36(11): 1035–41 [PubMed: 17786434] | Other protocol criteria - study reported in an included systematic review (Thawait 2012) |
| Tariq, G., Singh, M., Feroze, S. et al (2000) MRI-Evaluation of spinal pathology. JK Practitioner 7(3): 162–166 | Study design – does not match protocol |
| Taskin, G.; Incesu, L.; Aslan, K. (2013) The value of apparent diffusion coefficient measurements in the differential diagnosis of vertebral bone marrow lesions. Turkish Journal of Medical Sciences 43(3): 379–387 | Reference standard – does not match protocol |
| Taylor, B V, Kimmel, D W, Krecke, K N et al (1997) Magnetic resonance imaging in cancer-related lumbosacral plexopathy. Mayo Clinic proceedings 72(9): 823–9 [PubMed: 9294528] | Population – does not match protocol |
| Thawait, Shrey K, Kim, Jihoon, Klufas, Roman A et al (2013) Comparison of four prediction models to discriminate benign from malignant vertebral compression fractures according to MRI feature analysis. AJR. American journal of roentgenology 200(3): 493–502 [PubMed: 23436836] | Outcomes – do not match protocol |
| Thawait, Shrey K, Marcus, Matthew A, Morrison, William B et al (2012) Research synthesis: what is the diagnostic performance of magnetic resonance imaging to discriminate benign from malignant vertebral compression fractures? Systematic review and meta-analysis. Spine 37(12): e736–44 [PubMed: 22210011] | Other protocol criteria - systematic review - included studies were assessed for relevance |
| Thomson, V., Pialat, J.-B., Gay, F. et al (2008) Whole-body MRI for metastases screening: A preliminary study using 3D VIBE sequences with automatic subtraction between noncontrast and contrast enhanced images. American Journal of Clinical Oncology: Cancer Clinical Trials 31(3): 285–292 [PubMed: 18525309] | Population – does not match protocol |
| Tokuda, Osamu, Harada, Yuko, Ueda, Takaaki et al (2011) Malignant versus benign vertebral compression fractures: can we use bone SPECT as a substitute for MR imaging?. Nuclear medicine communications 32(3): 192–8 [PubMed: 21150808] | Other protocol criteria - study reported in an included systematic review (Li 2019) |
| Traub-Weidinger, T, Von Guggenberg, E, Dobrozemsky, G et al (2010) Preliminary experience with (68)Ga-DOTA-lanreotide positron emission tomography. The quarterly journal of nuclear medicine and molecular imaging : official publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology (IAR), [and] Section of the Society of... 54(1): 52–60 [PubMed: 20168286] | Outcomes – do not match protocol |
| Tzeng, Y.-H., Chang, T.-Y., Huang, G.-S. et al (2004) Diffusion-weighted MR imaging for differentiating acute benign from pathologic compression fractures: A reinvestigation of the usefulness of diffusion-weighted imaging. Chinese Journal of Radiology 29(3): 109–115 | Other protocol criteria - study reported in an included systematic review (Thawait 2012) |
| Uchida, Kenzo, Nakajima, Hideaki, Miyazaki, Tsuyoshi et al (2013) (18)F-FDG PET/CT for Diagnosis of Osteosclerotic and Osteolytic Vertebral Metastatic Lesions: Comparison with Bone Scintigraphy. Asian spine journal 7(2): 96–103 [PMC free article: PMC3669709] [PubMed: 23741546] | Outcomes – do not match protocol |
| Van Veldhuizen, P J and Stephens, R L (1993) Evaluation of neoplastic spinal cord compressions. Kansas medicine : the journal of the Kansas Medical Society 94(5): 130–2 [PubMed: 8326693] | Outcomes – do not match protocol |
| Venkitaraman, R, Sohaib, S A, Barbachano, Y et al (2007) Detection of occult spinal cord compression with magnetic resonance imaging of the spine. Clinical oncology (Royal College of Radiologists (Great Britain)) 19(7): 528–31 [PubMed: 17499490] | Outcomes – do not match protocol |
| Venkitaraman, Ramachandran, Barbachano, Yolanda, Dearnaley, David P et al (2007) Outcome of early detection and radiotherapy for occult spinal cord compression. Radiotherapy and oncology, 85(3): 469–72 [PubMed: 18036691] | Study design – does not match protocol |
| Wang, Juan, Fang, Zhiyuan, Lang, Ning et al (2017) A multi-resolution approach for spinal metastasis detection using deep Siamese neural networks. Computers in biology and medicine 84: 137–146 [PMC free article: PMC6042511] [PubMed: 28364643] | Population – does not match protocol |
| Wang, Li-Xia, Kong, Xiang-Quan, Shi, He-Shui et al (2007) Application value of magnetic resonance sequences in diagnosis of early spinal metastatic tumor. Chinese medical sciences journal = Chung-kuo i hsueh k’o hsueh tsa chih 22(1): 9–12 [PubMed: 17441310] | Outcomes – do not match protocol |
| Wang, Z., Yuan, L., Ma, D. et al (2016) 18F-FDG PET/CT can differentiate vertebral metastases from Schmorl’s nodes by distribution characteristics of the 18F-FDG. Hellenic Journal of Nuclear Medicine 19(3): 241–244 [PubMed: 27824963] | Outcomes – do not match protocol |
| White, Andrew P, Kwon, Brian K, Lindskog, Dieter M et al (2006) Metastatic disease of the spine. The Journal of the American Academy of Orthopaedic Surgeons 14(11): 587–98 [PubMed: 17030592] | Study design – does not match protocol |
| White, N. (2016) Metastatic Spinal Cord Compression: Presentation, Diagnosis, and Management. Hospital Medicine Clinics 5(3): 452–465 | Study design – does not match protocol |
| Wonglaksanapimon, Suwimon, Chawalparit, Orasa, Khumpunnip, Sutiporn et al (2012) Vertebral body compression fracture: discriminating benign from malignant causes by diffusion-weighted MR imaging and apparent diffusion coefficient value. Journal of the Medical Association of Thailand = Chotmaihet thangphaet 95(1): 81–7 [PubMed: 22379746] | Other protocol criteria - study reported in an included systematic review (Li 2019) |
| Wu, X., Ma, C., Zhao, X. et al (2010) Application of whole body diffusion weighted imaging in bone metastasis. Chinese-German Journal of Clinical Oncology 9(1): 44–47 | Outcomes – do not match protocol |
| Yang, Z., Shi, W., Zhu, B. et al (2014) Is 18F-FDG PET/CT more reliable than 99mTc-MDP planar bone scintigraphy in detecting bone metastasis in nasopharyngeal carcinoma?. Annals of Nuclear Medicine 28(5): 411–416 [PubMed: 24610681] | Population – does not match protocol |
| Yao, W.W., Li, M.H., Yang, S.X. et al (2005) Use of diffusion-weighted magnetic resonance imaging to differentiate between acute benign and pathological vertebral fractures: Prospective study. Journal of the Hong Kong College of Radiologists 8(1): 4–8 | Outcomes – do not match protocol |
| Yilmaz Ovali, G., Duzgun, F., Farasat, M. et al (2017) Benign versus malignant vertebral compression, chemical shift MR imaging, is it useful?. Iranian Journal of Radiology 14(2): e42016 | Other protocol criteria - study reported in an included systematic review (Suh 2018) |
| Yueniwati, Yuyun and Widhiasi, Dhanti Erma (2015) Role of Magnetic Resonance Imaging in Differentiating Spondylitis from Vertebral Metastasis. Asian spine journal 9(5): 776–82 [PMC free article: PMC4591451] [PubMed: 26435798] | Outcomes – do not match protocol |
| Zajick, Donald C Jr, Morrison, William B, Schweitzer, Mark E et al (2005) Benign and malignant processes: normal values and differentiation with chemical shift MR imaging in vertebral marrow. Radiology 237(2): 590–6 [PubMed: 16244268] | Outcomes – do not match protocol |
| Zampa, Virna, Cosottini, Mirco, Michelassi, Chiara et al (2002) Value of opposed-phase gradient-echo technique in distinguishing between benign and malignant vertebral lesions. European radiology 12(7): 1811–8 [PubMed: 12111073] | Other protocol criteria - study reported in an included systematic review (Li 2019) |
| Zeng, K Liang, Myrehaug, Sten, Soliman, Hany et al (2019) Stereotactic Body Radiotherapy for Spinal Metastases at the Extreme Ends of the Spine: Imaging-Based Outcomes for Cervical and Sacral Metastases. Neurosurgery 85(5): 605–612 [PubMed: 30169694] | Study design – does not match protocol |
| Zhang, J., Chen, Y., Zhang, E. et al (2020) Diagnosis of spinal lesions using perfusion parameters measured by DCE-MRI and metabolism parameters measured by PET/CT. European Spine Journal 29(5): 1061–1070 [PMC free article: PMC7709817] [PubMed: 31754820] | Population – does not match protocol |
| Zhang, Jiahui, Chen, Yongye, Zhang, Enlong et al (2020) Use of monoexponential diffusion-weighted imaging and diffusion kurtosis imaging and dynamic contrast-enhanced-MRI for the differentiation of spinal tumors. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 29(5): 1112–1120 [PubMed: 32040617] | Population – does not match protocol |
| Zhang, Yiqiu, Shi, Hongcheng, Cheng, Dengfeng et al (2013) Added value of SPECT/spiral CT versus SPECT in diagnosing solitary spinal lesions in patients with extraskeletal malignancies. Nuclear medicine communications 34(5): 451–8 [PubMed: 23442544] | Index test – does not match protocol |
| Zhang, Yiqiu, Shi, Hongcheng, Gu, Yushen et al (2011) Differential diagnostic value of single-photon emission computed tomography/spiral computed tomography with Tc-99m-methylene diphosphonate in patients with spinal lesions. Nuclear medicine communications 32(12): 1194–200 [PubMed: 21934544] | Index test – does not match protocol |
| Zhou, X.J., Leeds, N.E., McKinnon, G.C. et al (2002) Characterization of benign and metastatic vertebral compression fractures with quantitative diffusion MR imaging. American Journal of Neuroradiology 23(1): 165–170 [PMC free article: PMC7975517] [PubMed: 11827890] | Other protocol criteria - study reported in an included systematic review (Thawait 2012) |
| Zidan, D.Z.; Habib, L.A.; Chalabi, N.A. (2014) Quantitative chemical-shift MR imaging cutoff value: Benign versus malignant vertebral compression - Initial experience. Egyptian Journal of Radiology and Nuclear Medicine 45(3): 779–786 | Other protocol criteria - study reported in an included systematic review (Suh 2018) |
Excluded economic studies
No economic evidence was identified for this review. See supplement 2 for further information.
Appendix K. Research recommendations – full details
Research recommendations for review question: How effective are radiological imaging techniques in the diagnosis of spinal metastases, direct malignant infiltration of the spine or associated spinal cord compression?
No research recommendations were made for this review question.
Appendix L. Study data - diagnostic accuracy
Final version
Evidence reviews underpinning recommendations 1.5.1, 1.5.5 to 1.5.9 in the NICE guideline
These evidence reviews were developed by NICE
Disclaimer: The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The recommendations in this guideline are not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.
Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.
NICE guidelines cover health and care in England. Decisions on how they apply in other UK countries are made by ministers in the Welsh Government, Scottish Government, and Northern Ireland Executive. All NICE guidance is subject to regular review and may be updated or withdrawn.
- Review A systematic review of evidence on malignant spinal metastases: natural history and technologies for identifying patients at high risk of vertebral fracture and spinal cord compression.[Health Technol Assess. 2013]Review A systematic review of evidence on malignant spinal metastases: natural history and technologies for identifying patients at high risk of vertebral fracture and spinal cord compression.Sutcliffe P, Connock M, Shyangdan D, Court R, Kandala NB, Clarke A. Health Technol Assess. 2013 Sep; 17(42):1-274.
- Review Evidence reviews for investigations – management: Spinal metastases and metastatic spinal cord compression: Evidence review G[ 2023]Review Evidence reviews for investigations – management: Spinal metastases and metastatic spinal cord compression: Evidence review G. 2023 Sep
- More advantages in detecting bone and soft tissue metastases from prostate cancer using (18)F-PSMA PET/CT.[Hell J Nucl Med. 2019]More advantages in detecting bone and soft tissue metastases from prostate cancer using (18)F-PSMA PET/CT.Pianou NK, Stavrou PZ, Vlontzou E, Rondogianni P, Exarhos DN, Datseris IE. Hell J Nucl Med. 2019 Jan-Apr; 22(1):6-9. Epub 2019 Mar 7.
- Review Imaging of Spinal Bone Tumors: Principles and Practice.[Curr Med Imaging. 2022]Review Imaging of Spinal Bone Tumors: Principles and Practice.Tsukamoto S, Mavrogenis AF, Langevelde KV, Vucht NV, Kido A, Errani C. Curr Med Imaging. 2022; 18(2):142-161.
- Review Fluorine-18-fluorodeoxyglucose (FDG) positron emission tomography (PET) computed tomography (CT) for the detection of bone, lung, and lymph node metastases in rhabdomyosarcoma.[Cochrane Database Syst Rev. 2021]Review Fluorine-18-fluorodeoxyglucose (FDG) positron emission tomography (PET) computed tomography (CT) for the detection of bone, lung, and lymph node metastases in rhabdomyosarcoma.Vaarwerk B, Breunis WB, Haveman LM, de Keizer B, Jehanno N, Borgwardt L, van Rijn RR, van den Berg H, Cohen JF, van Dalen EC, et al. Cochrane Database Syst Rev. 2021 Nov 9; 11(11):CD012325. Epub 2021 Nov 9.
- Evidence reviews for investigations – diagnosisEvidence reviews for investigations – diagnosis
Your browsing activity is empty.
Activity recording is turned off.
See more...