Table 1.

Optimal/favored imaging modality/sequence based on clinical question

Clinical question	Optimal imaging modality/sequence	Considerations
Presence of osteoblastic metastases	99mTc-MDP	Poor specificity, afftected by ‘flare’ reactions
Presence of osteolytic or osteoblastic metastases, active disease residuum versus treatment response	FDG-PET/CT WB-MRI	WB-MRI not widely available as yet, longer image acquisition times and requirement to train radiologists in interpretation
Presence of parenchymal CNS metastases	Contrast-enhanced T1 MRI	Higher sensitivity in detection of parenchymal versus leptomeningeal disease
Presence of leptomenigeal disease	Contrast-enhanced FLAIR MRI	Limited, small-scale studies
Residual CNS disease versus treatment-related effects	CCA	Inherently lengthy image acquisition times, require dedicated neuroradiology interpretation
Presence of hepatic metastases	CT LIVER MRI WB-MRI	Differentiating active disease residuum from pseudo-cirrhosis of malignancy often challenging on CT
Residual hepatic disease versus pseudo-cirrhosis of malignancy	WB-MRI	Interpretation influenced by radiologist experience
Presence of oligometastatic disease	FDG-PET/CT WB-MRI	WB-MRI less widely available than FDG-PET/CT
Presence of peritoneal carcinomatosis	WB-MRI	WB-MRI not widely available as yet as above