Tumor infiltration of bone marrow in patients with hematological malignancies: dynamic contrast-enha

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Background Conventional magnetic resonance (MR) scanning techniques can identify bone marrow (BM)containing mostly fat cells. But they are not able to differentiate BM tumor infiltration, BM fibrosis and normalred BM. This is particularly problematic in assessment of recurrent or refractory hematological malignancy. Thispilot study used dynamic contrast-enhanced MR imaging (DCE-MRI) to evaluate the bone marrow status and todetermine whether several calculated parameters derived from the DCE-MRI correlate with histologicalcharacteristics of marrow, especially with the tumor fraction (TF).Methods DCE-MRI scans were performed in 25 patients with proven or known hematological malignancy whowere about to undergo bone marrow biopsy of the posterior iliac crest. The location chosen for biopsy wasexamined with MRI approximately one hour prior to the biopsy. Time-signal intensity curves (TIC) weregenerated from the region of the iliac crest corresponding to the planned biopsy site. Enhancement parameterswere calculated, including peak enhancement ratio (PER), maximum enhancement slope (Slopemax), time to peak(TTP) and mean time (MT). The biopsy specimen was reported synoptically, with relevant reported parametersincluding cellularity and tumor fraction (TF).Results PER values were significantly higher for the bone marrow tumor infiltration group than for the normalbone marrow group (P<0.05). A significant positive correlation was found between PER and TF as well asSlopemax and TF. A negative correlation was found between TTP and TF. There was no significant difference inthe mean TTP and MT values between the BM tumor infiltration group and the normal bone marrow group.Conclusions The presence of diffuse bone marrow infiltration in patients with haematological malignanciescould be verified using DCE-MRI.
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