Spine

Hi ocaders

A case of 79 years old man with weakness of neck proximal hip muscles
T1 rounded hypointense lesions image showed one lesion)

I attached t1, IN/OPP images, not sure IN/OPP scans are helpful to
differentiate benign vs malignant BM lesions.

What’s your opinion?
?mets
Unable to give gadolinium due to low egfr 33

Thanks