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Evaluation of prostate cancer patients with suspected bone metastases has not changed in several decades. Technetium-99m bone scintigraphy (bone scans), with or without plain radiographs of equivocal areas, remains the standard of care for assessment. However, bone scans are inherently problematic, as this imaging modality has relatively poor specificity for identifying metastatic disease, and additional studies often are required to rule out metastases.
A group from Belgium performed a prospective evaluation of magnetic resonance imaging (MRI) of the axial skeleton as a single-step detection method versus multistep detection with bone scans plus follow-up modalities. They enrolled 66 asymptomatic high-risk patients with prostate cancer: 26 …