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obtained, have entered into widespread clinical use in recent years. PET/CT thus
combines the high spatial resolution anatomic information of CT scanning with the
physiologic/metabolic information of the tissue obtained from PET imaging to
assess regions of pathology. A disadvantage of all X-ray and gamma ray imaging
modalities is the associated risk of ionizing radiation exposure to the patient.
Magnetic Resonance (MR) imaging provides a high level of soft tissue contrast,
optimal for detection of early bone marrow deposits, and is useful for assessing for
spinal cord injury and epidural tumors. Additionally, MRI does not involve ionizing
radiation exposure to the patient. Disadvantages of MRI include the relatively long
scanning time compared to CT which limits its usefulness for scanning unstable
patients in emergent situations, and also makes it more susceptible to patient motion
artifact
Moreover, MRI cannot be used for patients with medical appliances such
as certain types of pacemakers and cerebral aneurysm coils, and it suffers image
distortion in patients with metallic orthopedic hardware [
18
]. Although numerous
and varying imaging modalities are currently available, and may be situationally
targeted toward speci
…
c classes of neoplastic processes, CT remains a widely used
high resolution modality for detection and surveillance of many types of cancer,
particularly in a community hospital setting. CT is also the most cost effective 3D
imaging modality. In the case of prostate cancer, the major role of CT for skeletal
imaging is the detection and anatomic localization of bone metastases [
19
].
Examples of CT images of lytic and sclerotic bone metastases in the spine are
shown in Fig.
1
.
Fig. 1 Examples of lytic and sclerotic metastases in the spine. First row lytic metastases. Second
row sclerotic metastases
