Reason: lung cancer, EGFR mutated, back pain at L1, ? met History: back pain Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall alignment and height. The conus medullaris on sagittal imaging is grossly intact.There are multiple marrow replacing lesions present within the lumbar spine at L1, L4 and S2 without associated compression fractures over compromise the spinal canal. The largest one is at L4 measuring approximately 21 by 29 mm in sagittal dimensions along the right posterior lateral aspect of L4 vertebral body. Additional marrow replacing lesion is present at T11 centered along the right pedicle. An L2 vertebral body lesion which is hyperintense on T1 and suppresses on fat suppressed images suspected to represent a vertebral body hemangioma.There is multilevel disk desiccation and loss of disk space height present.At L5-S1 there is no significant compromise to spinal canal or neural foramina. There is a minor disk bulge at this level.At L4-5 there is no significant compromise to spinal canal or neural foramina. There is a minor disk bulge at this level. There is a mild disk bulge at this level .At L3-4 there is no significant compromise to spinal canal or neural foramina.At L2-3 there is no significant compromise to spinal canal or neural foramina.At L1-2 there is no significant compromise to spinal canal or neural foramina.
1.Multiple marrow replacing lesions are present in the lumbar spine which are suspicious for metastatic disease.