Spinal magnetic resonance imaging used to delay or prevent the progression of spinal cord compression

Spinal cord compression (SCC) is a major complication of metastatic castration-resistant prostate cancer (CRPC) and the onset of SCC is associated with potentially severe neurological problems.

Because targeted radiotherapy can be used to delay or prevent the SCC progression, an English team of radiologists has attempted to determine the optimal frequency of spinal magnetic resonance imaging (MRI) to detect SCC by analyzing clinical data from 130 consecutive patients with CRPC.The authors conclude that spinal MRIs can be used to detect asymptomatic SCC in patients with CRPC, but is most effective when SCC are detected as early as reasonably possible. The serial MRIs are required to maintain a low incidence of clinical SCC and that the optimum frequency of the MRIs depends on the subset of patients studied. Based on the results of their study, radiologists suggest that the optimal frequency for spinal MRIs would be every 4-6 months for CRPC patients with previous SCC, rapid or high PSA or back pain and annually for patients with CRPC but no symptoms suggestive of SCC.