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Diagnosis
Perivertebral Space
Benign and Malignant Tumors
Vertebral Body Metastasis in Perivertebral Space
Vertebral Body Metastasis in Perivertebral Space
C. Douglas Phillips, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Vertebral body (VB) metastasis in perivertebral space (PVS)

            • Definitions

              • Metastatic tumor to cervical VB ± invasion of PVS

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Nuclear Medicine Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Staging, Grading, & Classification

                              • Gross Pathologic & Surgical Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Pricolo P et al: Whole-body magnetic resonance imaging (WB-MRI) reporting with the METastasis Reporting and Data System for Prostate Cancer (MET-RADS-P): inter-observer agreement between readers of different expertise levels. Cancer Imaging. 20(1):77, 2020
                                            2. Hussain AK et al: The impact of metastatic spinal tumor location on 30-day perioperative mortality and morbidity after surgical decompression. Spine (Phila Pa 1976). 43(11):E648-55, 2018
                                            3. Mesfin A et al: Management of metastatic cervical spine tumors. J Am Acad Orthop Surg. 23(1):38-46, 2015
                                            4. Patel KB et al: Diffusion-weighted MRI "claw sign" improves differentiation of infectious from degenerative modic type 1 signal changes of the spine. AJNR Am J Neuroradiol. 35(8):1647-52, 2014
                                            5. Prince EA et al: Interventional management of vertebral body metastases. Semin Intervent Radiol. 30(3):278-81, 2013
                                            6. Grankvist J et al: MRI and PET/CT of patients with bone metastases from breast carcinoma. Eur J Radiol. 81(1):e13-8, 2012
                                            7. Eleraky M et al: Management of metastatic spine disease. Curr Opin Support Palliat Care. 4(3):182-8, 2010
                                            8. Chawla S et al: Stereotactic radiosurgery for spinal metastases: case report and review of treatment options. Bone. 45(4):817-21, 2009
                                            9. Fehlings MG et al: Decision making in the surgical treatment of cervical spine metastases. Spine (Phila Pa 1976). 34(22 Suppl):S108-17, 2009
                                            10. Gerszten PC et al: Radiotherapy and radiosurgery for metastatic spine disease: what are the options, indications, and outcomes? Spine (Phila Pa 1976). 34(22 Suppl):S78-92, 2009
                                            11. Kim DS et al: Magnetic resonance imaging diagnoses of bone scan abnormalities in breast cancer patients. Nucl Med Commun. 30(9):736-41, 2009
                                            12. Kwon YM et al: Survival rate and neurological outcome after operation for advanced spinal metastasis (Tomita's classification > or = type 4). Yonsei Med J. 50(5):689-96, 2009
                                            13. Laufer I 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(1):107-13; discussion 113-4, 2009
                                            14. Lee B et al: The efficacy of percutaneous vertebroplasty for vertebral metastases associated with solid malignancies. Eur J Cancer. 45(9):1597-602, 2009
                                            15. Venkitaraman R et al: Whole-body magnetic resonance imaging in the detection of skeletal metastases in patients with prostate cancer. J Med Imaging Radiat Oncol. 53(3):241-7, 2009
                                            16. Cascini G et al: Whole-body magnetic resonance imaging for detecting bone metastases: comparison with bone scintigraphy. Radiol Med. 113(8):1157-70, 2008
                                            17. Feiz-Erfan I et al: The role of surgery in the management of metastatic spinal tumors. Semin Oncol. 35(2):108-17, 2008
                                            18. Rodallec MH et al: Diagnostic imaging of solitary tumors of the spine: what to do and say. Radiographics. 28(4):1019-41, 2008
                                            19. Guillevin R et al: Spine metastasis imaging: review of the literature. J Neuroradiol. 34(5):311-21, 2007
                                            20. Tokuhashi Y et al: A revised scoring system for preoperative evaluation of metastatic spine tumor prognosis. Spine (Phila Pa 1976). 30(19):2186-91, 2005
                                            21. Bauer H et al: Surgical strategy for spinal metastases. Spine (Phila Pa 1976). 27(10):1124-6, 2002
                                            22. Taoka T et al: Factors influencing visualization of vertebral metastases on MR imaging versus bone scintigraphy. AJR Am J Roentgenol. 176(6):1525-30, 2001
                                            23. Davis WL et al: CT and MRI of the normal and diseased perivertebral space. Neuroradiology. 37(5):388-94, 1995
                                            24. Mehta RC et al: MR evaluation of vertebral metastases: T1-weighted, short-inversion-time inversion recovery, fast spin-echo, and inversion-recovery fast spin-echo sequences. AJNR Am J Neuroradiol. 16(2):281-8, 1995
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Pathology

                                                    • Clinical Issues

                                                      TERMINOLOGY

                                                      • Abbreviations

                                                        • Vertebral body (VB) metastasis in perivertebral space (PVS)

                                                      • Definitions

                                                        • Metastatic tumor to cervical VB ± invasion of PVS

                                                      IMAGING

                                                      • General Features

                                                        • Radiographic Findings

                                                          • CT Findings

                                                            • MR Findings

                                                              • Nuclear Medicine Findings

                                                                • Imaging Recommendations

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      • Staging, Grading, & Classification

                                                                        • Gross Pathologic & Surgical Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Demographics

                                                                              • Natural History & Prognosis

                                                                                • Treatment

                                                                                  DIAGNOSTIC CHECKLIST

                                                                                  • Consider

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Pricolo P et al: Whole-body magnetic resonance imaging (WB-MRI) reporting with the METastasis Reporting and Data System for Prostate Cancer (MET-RADS-P): inter-observer agreement between readers of different expertise levels. Cancer Imaging. 20(1):77, 2020
                                                                                      2. Hussain AK et al: The impact of metastatic spinal tumor location on 30-day perioperative mortality and morbidity after surgical decompression. Spine (Phila Pa 1976). 43(11):E648-55, 2018
                                                                                      3. Mesfin A et al: Management of metastatic cervical spine tumors. J Am Acad Orthop Surg. 23(1):38-46, 2015
                                                                                      4. Patel KB et al: Diffusion-weighted MRI "claw sign" improves differentiation of infectious from degenerative modic type 1 signal changes of the spine. AJNR Am J Neuroradiol. 35(8):1647-52, 2014
                                                                                      5. Prince EA et al: Interventional management of vertebral body metastases. Semin Intervent Radiol. 30(3):278-81, 2013
                                                                                      6. Grankvist J et al: MRI and PET/CT of patients with bone metastases from breast carcinoma. Eur J Radiol. 81(1):e13-8, 2012
                                                                                      7. Eleraky M et al: Management of metastatic spine disease. Curr Opin Support Palliat Care. 4(3):182-8, 2010
                                                                                      8. Chawla S et al: Stereotactic radiosurgery for spinal metastases: case report and review of treatment options. Bone. 45(4):817-21, 2009
                                                                                      9. Fehlings MG et al: Decision making in the surgical treatment of cervical spine metastases. Spine (Phila Pa 1976). 34(22 Suppl):S108-17, 2009
                                                                                      10. Gerszten PC et al: Radiotherapy and radiosurgery for metastatic spine disease: what are the options, indications, and outcomes? Spine (Phila Pa 1976). 34(22 Suppl):S78-92, 2009
                                                                                      11. Kim DS et al: Magnetic resonance imaging diagnoses of bone scan abnormalities in breast cancer patients. Nucl Med Commun. 30(9):736-41, 2009
                                                                                      12. Kwon YM et al: Survival rate and neurological outcome after operation for advanced spinal metastasis (Tomita's classification > or = type 4). Yonsei Med J. 50(5):689-96, 2009
                                                                                      13. Laufer I 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(1):107-13; discussion 113-4, 2009
                                                                                      14. Lee B et al: The efficacy of percutaneous vertebroplasty for vertebral metastases associated with solid malignancies. Eur J Cancer. 45(9):1597-602, 2009
                                                                                      15. Venkitaraman R et al: Whole-body magnetic resonance imaging in the detection of skeletal metastases in patients with prostate cancer. J Med Imaging Radiat Oncol. 53(3):241-7, 2009
                                                                                      16. Cascini G et al: Whole-body magnetic resonance imaging for detecting bone metastases: comparison with bone scintigraphy. Radiol Med. 113(8):1157-70, 2008
                                                                                      17. Feiz-Erfan I et al: The role of surgery in the management of metastatic spinal tumors. Semin Oncol. 35(2):108-17, 2008
                                                                                      18. Rodallec MH et al: Diagnostic imaging of solitary tumors of the spine: what to do and say. Radiographics. 28(4):1019-41, 2008
                                                                                      19. Guillevin R et al: Spine metastasis imaging: review of the literature. J Neuroradiol. 34(5):311-21, 2007
                                                                                      20. Tokuhashi Y et al: A revised scoring system for preoperative evaluation of metastatic spine tumor prognosis. Spine (Phila Pa 1976). 30(19):2186-91, 2005
                                                                                      21. Bauer H et al: Surgical strategy for spinal metastases. Spine (Phila Pa 1976). 27(10):1124-6, 2002
                                                                                      22. Taoka T et al: Factors influencing visualization of vertebral metastases on MR imaging versus bone scintigraphy. AJR Am J Roentgenol. 176(6):1525-30, 2001
                                                                                      23. Davis WL et al: CT and MRI of the normal and diseased perivertebral space. Neuroradiology. 37(5):388-94, 1995
                                                                                      24. Mehta RC et al: MR evaluation of vertebral metastases: T1-weighted, short-inversion-time inversion recovery, fast spin-echo, and inversion-recovery fast spin-echo sequences. AJNR Am J Neuroradiol. 16(2):281-8, 1995