CT/MRI Whole Spine — MSCC [INPATIENT]
CT/MRINICE NG2342023 (Replaces CG75)v2.0 · March 2026
Within 24 hours
Inpatient
Indications — in known cancer patient
— ANY of the following
- New or progressive back pain (especially thoracic, nocturnal, or unremitting)
- Neurological signs: weakness, sensory loss, bladder/bowel dysfunction, gait disturbance
- Any cancer patient with unexplained progressive spinal pain and neurological symptoms
Imaging requirements
— ALL of the following must be met
- MRI of WHOLE SPINE: sagittal T1 and/or STIR plus sagittal T2 and axial through significant abnormalitiesNICE NG234 Rec 1.5.5
- Must include ENTIRE spine — not just symptomatic regionNICE NG234 Rec 1.5.4
- Do NOT perform plain radiographyNICE NG234 Rec 1.5.9
- If MRI contraindicated: CT with contrastNICE NG234 Rec 1.5.7
Notes
Alert
Contact MSCC coordinator urgently
NICE NG234 Rec 1.3.2Warning
Do NOT perform plain radiography to diagnose or exclude MSCC
Information
CG75 (2008) fully superseded by NG234 (2023)
Modality Preference
MRI preferred. MRI is first-line for MSCC — CT only if MRI contraindicated
Source: NICE NG234 Rec 1.5.5
Guideline Corrections
CG75 → NG234 (2023)
CG75 fully superseded by NG234 in 2023
Change Log
v2.02026-03-08New protocol — metastatic spinal cord compression. References NG234 (replaces CG75).