Evaluation of the patterns of bone marrow involement in non - hodgkin's lymphoma by bone marrow mri with correlation to bone marrow biopsy and response to chemotherapy

Abstract EN

Methods and Materials : Forty-two consecutive patients with De novo non-Hodgkin's lymphoma were examined by MRI and bone marrow biopsy to detect bone marrow infiltration.

MRI of the femoral or humeral marrow was obtained by T1-weighted spin echo method and the short T1 inversion recovery technique.

Results : Twenty-three patients (54.8 %) had abnormal positive MRIs of the femoral or humeral marrow on both T1-weighted SE and STIR images.

In thirteen patients out of them, bone marrow aspiration and biopsy results was co-ordinate with MRI findings and revealed bone marrow infiltration.

While, in ten patients, suspected infiltration was detected with MRI, without histologic evidence for bone marrow involvement, follow-up of those ten patients after treatment with chemotherapy revealed that only one patient (2.4 %) still had abnormal signal intensity on MRI.

Three abnormal MRI patterns were observed scattered (65.2 %), uniform (21.7 %) and nodular (13.1 %).

There was no correlation between the pattern of involvement and his-tologic subtype.

Abnormal MRI studies were not significantly correlated with clinical parameters such as B symptoms, generalized bone pain or biochemical parameters such as elevated serum level of LDH or alkaline phosphatase.

Conclusion : in conclusion, the present results showed that MRI may be effective in evaluation of bone marrow infiltration in malignant lymphoma and provide a non-invasive and sensitive approach for imaging of bone marrow, therefore, MR imaging can be included routinely in the staging of malignant lymphoma as an adjunct to blind bone marrow aspiration and biopsy in the evaluation of bone marrow status.