Bibliotheca radiologica

Bone metastases are a common occurrence in carcinoma of the breast, prostate and lung. An understanding of the basic biology of metastatic disease is important for an appreciation of the selective nature of these tumour metastases for bone. Biomechanics of metastatic disease helps explain the proclivity of most metastatic disease for the vertebral column. An understanding of pathophysiology and biochemistry helps in understanding how some tumours produce osteolytic versus osteoblastic or mixed lesions and the relative risks of these deposits. This knowledge leads to an understanding of the difficulties in imaging these lesions and how best to utilize techniques such as SPECT/CT, MRI and PET/CT