MRI s are expensive and generally one does not look at the whole skeleton with them mainly just the spine. As long as a patient with aipc is assymptomatic, there is really no need to know the site and number of all boney mets. Many in fact most boney mets never grow to a point where they cause symptoms or require local treatment such as radiation. Because we cant predict in advance which mets will cause future problems, we usually wait for symptoms to develop before we investigate further.
Research studies become more cumbersome and expensive with the use of mris. Its true that the number of bone mets are used as a prognostic factor but it is a soft predictor of longevity. PSA velocity id the main determinate of survival. Since previous trials use bone scans, the prognostic significance of finding the additional lesions is uncertain. So i doubt mris will be used for prognostic stratifications but they are probably better than bone scans in measuring response to treatment.
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