CT Thoracic Spine Without IV Contrast CT thoracic spine without IV contrast may be helpful for presurgical planning or to delineate the osseous anatomy, particularly if there is osseous destruction [37]. FDG-PET/CT Skull Base to Mid-Thigh There is no relevant literature to support the use of FDG-PET/CT skull base to mid-thigh in the initial imaging assessment of this group. MRI Thoracic Spine With IV Contrast MRI thoracic spine with IV contrast is not typically performed independently as an initial study, because its interpretation is most informative when correlated with standard noncontrast sequences included in MRI thoracic spine with and without IV contrast. MRI Thoracic Spine Without and With IV Contrast MRI without and with IV contrast is the initial imaging modality of choice in patients with TBP and suspected neoplasm or infection [36,38-42]. Thoracic Back Pain MRI Thoracic Spine Without IV Contrast MRI without IV contrast may be useful in this setting to identify marrow replacing lesions, osseous destruction, canal compromise, and cord signal abnormality. However, the addition of postcontrast sequences would be more sensitive in identifying thoracic spinal infection and its complications, assessing small marrow replacing lesions, and identifying intradural disease [39-44]. Radiography Thoracic Spine Radiographs have low sensitivity but may be useful in the urgent/emergent setting to identify osseous destruction or change in alignment in patients with TBP and suspected infection or neoplasm [45]. Variant 6: Adult. Thoracic back pain without or with myelopathy or radiculopathy. Radiograph shows bone destruction or fracture or spinal deformity. Next imaging study. In patients with TBP and osseous destruction or spinal deformity the role of imaging is to delineate osseous detail and anatomy and assess the integrity of the soft tissue and neural structures, particularly that of the spinal canal.
Thoracic Back Pain. CT Thoracic Spine Without IV Contrast CT thoracic spine without IV contrast may be helpful for presurgical planning or to delineate the osseous anatomy, particularly if there is osseous destruction [37]. FDG-PET/CT Skull Base to Mid-Thigh There is no relevant literature to support the use of FDG-PET/CT skull base to mid-thigh in the initial imaging assessment of this group. MRI Thoracic Spine With IV Contrast MRI thoracic spine with IV contrast is not typically performed independently as an initial study, because its interpretation is most informative when correlated with standard noncontrast sequences included in MRI thoracic spine with and without IV contrast. MRI Thoracic Spine Without and With IV Contrast MRI without and with IV contrast is the initial imaging modality of choice in patients with TBP and suspected neoplasm or infection [36,38-42]. Thoracic Back Pain MRI Thoracic Spine Without IV Contrast MRI without IV contrast may be useful in this setting to identify marrow replacing lesions, osseous destruction, canal compromise, and cord signal abnormality. However, the addition of postcontrast sequences would be more sensitive in identifying thoracic spinal infection and its complications, assessing small marrow replacing lesions, and identifying intradural disease [39-44]. Radiography Thoracic Spine Radiographs have low sensitivity but may be useful in the urgent/emergent setting to identify osseous destruction or change in alignment in patients with TBP and suspected infection or neoplasm [45]. Variant 6: Adult. Thoracic back pain without or with myelopathy or radiculopathy. Radiograph shows bone destruction or fracture or spinal deformity. Next imaging study. In patients with TBP and osseous destruction or spinal deformity the role of imaging is to delineate osseous detail and anatomy and assess the integrity of the soft tissue and neural structures, particularly that of the spinal canal.