Do you routinely obtain a spine MRI for all patients planned for palliative spine RT?

If the treatment plan involves conventional EBRT for palliation of painful spine metastasis, reasonably identified on other imaging and correlating with the patient's location and nature of pain, I believe an MRI may not be necessary. However, if there are symptoms indicative of epidural spread or n...

I regularly administer palliative (non-SBRT) radiotherapy without performing an MRI spine or PET/CT scan.

If there's no concern for canal involvement based on clinical symptoms and diagnostic CT, additional tests are unlikely to alter management. Routinely including them can be demanding for patient...

If you've got a solitary lesion and you're trying to decide between treating with SBRT or giving 400 cGy x 5 or something, it would be reasonable to order an MRI beforehand, as depending on what it showed, you might change your management.

OTOH, why order an MRI on someone with widespread lytic mets...

Yes.