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Title: State-of-the-Art Imaging Techniques in Metastatic Spinal Cord Compression
Authors: Kuah, T
Vellayappan, BA 
Makmur, A
Nair, S
Song, J
Tan, JH
Kumar, N 
Quek, ST 
Hallinan, JTPD 
Keywords: Bilsky scale
deep learning
image-guided radiotherapy
metal artifact reduction
metastatic epidural spinal cord compression
metastatic spinal cord compression
stereotactic body radiotherapy
stereotactic radiosurgery
Issue Date: 1-Jul-2022
Publisher: MDPI AG
Citation: Kuah, T, Vellayappan, BA, Makmur, A, Nair, S, Song, J, Tan, JH, Kumar, N, Quek, ST, Hallinan, JTPD (2022-07-01). State-of-the-Art Imaging Techniques in Metastatic Spinal Cord Compression. Cancers 14 (13) : 3289-. ScholarBank@NUS Repository.
Abstract: Metastatic Spinal Cord Compression (MSCC) is a debilitating complication in oncology pa-tients. This narrative review discusses the strengths and limitations of various imaging modalities in diagnosing MSCC, the role of imaging in stereotactic body radiotherapy (SBRT) for MSCC treatment, and recent advances in deep learning (DL) tools for MSCC diagnosis. PubMed and Google Scholar databases were searched using targeted keywords. Studies were reviewed in consensus among the co-authors for their suitability before inclusion. MRI is the gold standard of imaging to diagnose MSCC with reported sensitivity and specificity of 93% and 97% respectively. CT Myelogram appears to have comparable sensitivity and specificity to contrast-enhanced MRI. Conventional CT has a lower diagnostic accuracy than MRI in MSCC diagnosis, but is helpful in emergent situations with limited access to MRI. Metal artifact reduction techniques for MRI and CT are continually being researched for patients with spinal implants. Imaging is crucial for SBRT treatment planning and three-dimensional positional verification of the treatment isocentre prior to SBRT delivery. Structural and functional MRI may be helpful in post-treatment surveillance. DL tools may improve detection of vertebral metastasis and reduce time to MSCC diagnosis. This enables earlier institution of definitive therapy for better outcomes.
Source Title: Cancers
ISSN: 20726694
DOI: 10.3390/cancers14133289
Appears in Collections:Staff Publications

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