Comparative diagnostic accuracy of magnetic resonance imaging and immunoscintigraphy for detection of bone marrow involvement in patients with malignant lymphoma.

Altehoefer, Carsten; Blum, Ulrich; Bathmann, J.; Wustenberg, Christine; Uhrmeister, Peter; Laubenberger, J; Lange, W.; Schwarzkopf, Jirka; Moser, E.; Langer, M.

doi:10.1200/jco.1997.15.5.1754

Cited by 49 publications

(23 citation statements)

References 24 publications

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“…A previous study reported that the false-negative rate was less than 2% for MRI, but from 10 to 20% for a blind biopsy in cases of focal distribution of bone marrow infiltration, particularly as seen in Hodgkin's lymphoma or high-grade non-Hodgkin's lymphoma and cases with no iliac bone marrow involvement [32].…”

Section: Discussionmentioning

confidence: 98%

Detection of bone marrow and extramedullary involvement in patients with non-Hodgkin?s lymphoma by whole-body MRI: comparison with bone and 67 Ga scintigraphies

et al. 2004

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The aim of this study was to evaluate the diagnostic potential of whole-body MRI (WB-MRI) for the detection of bone marrow and extramedullary involvement in patients with non-Hodgkin's lymphoma. WB-MRI, which was performed on 34 patients, consisted of the recording of T1-weighted spin-echo images and a fast STIR sequence covering the entire skeleton. The WB-MRI findings for bone marrow and extramedullary involvement were compared with those from (67)Ga and bone scintigraphies and bone marrow biopsy results. Two MRI specialists reviewed the WB-MRI results and two expert radiologists in the field of nuclear medicine reviewed the bone and (67)Ga scintigraphy findings. Bone marrow and extramedullary involvement of non-Hodgkin's lymphoma were confirmed by follow-up radiographs and CT and/or a histological biopsy. The detection rate of WB-MRI was high. More bone marrow involvement was detected by biopsy, and more lesions were detected by scintigraphies. In total, 89 lesions were detected by WB-MRI, whereas 15 were found by biopsy, 5 by (67)Ga scintigraphy, and 14 by bone scintigraphy. WB-MRI could also detect more extramedullary lesions than (67)Ga scintigraphy; i.e., 72 lesions were detected by WB-MRI, whereas 54 were discovered by (67)Ga scintigraphy. WB-MRI is useful for evaluating the involvement of bone marrow and extramedullary lesions throughout the skeleton in patients with non-Hodgkin's lymphoma.

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Section: Discussionmentioning

confidence: 98%

Detection of bone marrow and extramedullary involvement in patients with non-Hodgkin?s lymphoma by whole-body MRI: comparison with bone and 67 Ga scintigraphies

et al. 2004

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“…Detection of bone marrow disease may be more important in stages I-III than in stage IV, as the impact on prognosis and treatment will be greater. Hence, routine MR evaluation of bone marrow at initial staging should be considered, as has been suggested previously [10,12,33,34]. If the MR study were performed prior to biopsy, it could serve as guide to abnormal bone marrow foci and increase the yield of blind biopsies.…”

Section: Initial Stagingmentioning

confidence: 99%

Initial experience with FSE STIR whole-body MR imaging for staging lymphoma in children

et al. 2004

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Our objective was to compare fast spin-echo (FSE) short inversion time inversion recovery (STIR) whole-body MR imaging with standard procedures in staging children with lymphoma. Eight children (age range, 2-16 years) underwent multi-station FSE STIR whole-body MR at initial staging (n=5) or for restaging following completion of therapy (n=5). Whole-body MR and conventional staging procedures, including CT (n=10), gallium-67 scintigraphy (n=9), bone scintigraphy (n=3) and bone marrow biopsy (n=7) were retrospectively compared for detection of sites involved by lymphoma and for the assigned stage. FSE STIR whole-body MR detected more sites of possible lymphomatous involvement at initial staging (87/88) and at restaging (5/5) than did conventional imaging (74/88, 3/5). MR was more sensitive than conventional imaging in detecting bone marrow involvement at initial staging. Following treatment, however, residual and therapy-induced bone marrow signal abnormalities could not be differentiated from lymphomatous involvement. Detection of nodal and visceral involvement correlated well. Our results suggest that FSE STIR whole-body MR imaging is a sensitive technique for evaluating lymphomatous involvement of bone marrow as well as non-marrow sites. Larger prospective trials are needed to determine if FSE STIR whole-body MR can replace standard radiographic procedures for initial staging and contribute in the follow-up of lymphoma in children.

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“…1,[6][7][8][9][10][11][12] Bone marrow MR signal changes following bone marrow transplantation are well described and correlate with histological changes in bone marrow cell composition. 1,9 However, less attention has been paid to the development of a diagnostic method for the quantification of BMB permeability.…”

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confidence: 99%

Assessing permeability alterations of the blood–bone marrow barrier due to total body irradiation: in vivo quantification with contrast enhanced magnetic resonance imaging

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Rummeny

et al. 2000

Bone Marrow Transplant

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Summary:Our aim was to quantify irradiation-induced permeability alterations of the blood-bone marrow barrier (BMB) with dynamic contrast enhanced magnetic resonance imaging (MRI). The standard small molecular contrast agent, gadoterate meglumine, and a new macromolecular contrast agent, carboxymethyldextran-Gd-DOTA (CMD-Gd-DOTA), were compared. Twenty New Zealand white rabbits underwent MRI of the bone marrow before and 1-2 days after total body irradiation (TBI). Dynamic, repetitive T1-weighted MRI was performed before and after injection of either 0.05 mmol/kg BW CMD-Gd-DOTA (n = 10) or 0.5 mmol/kg BW gadoterate (n = 10). Bone marrow contrast enhancement was quantified as delta signal intensity: ⌬SI = ͉(SI post − SI pre ) / SI pre ͉ * 100%. All MRI data were compared with the histopathologic BMB ultrastructure. Dynamic bone marrow ⌬SI data steadily increased after CMD-Gd-DOTA injection, while blood ⌬SI data slightly decreased. This bone marrow contrast enhancement, indicative of contrast agent extravasation, was significantly higher and prolonged in the irradiated group as compared to non-irradiated controls (P Ͻ 0.05) and corresponded to irradiation-induced alterations of the BMB ultrastructure seen on electron microscopy. By contrast, ⌬SI data of non-irradiated and irradiated marrow were not significantly different following gadoterate injection (P Ͼ 0.05). We conclude that irradiation-induced alterations in BMB permeability could be reliably assessed with dynamic MRI, using the new macromolecular contrast agent CMD-Gd-DOTA. Bone Marrow Transplantation (2000) 25, 71-78.

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Comparative diagnostic accuracy of magnetic resonance imaging and immunoscintigraphy for detection of bone marrow involvement in patients with malignant lymphoma.

Abstract: Diagnostic imaging is essential for optimal staging in malignant lymphoma, as blind biopsies appear to have low sensitivity for bone marrow infiltration because of frequent involvement in noncrest marrow. both imaging modalities show a high rate of detection of bone marrow infiltration.

Cited by 49 publications

References 24 publications

Detection of bone marrow and extramedullary involvement in patients with non-Hodgkin?s lymphoma by whole-body MRI: comparison with bone and 67 Ga scintigraphies

Detection of bone marrow and extramedullary involvement in patients with non-Hodgkin?s lymphoma by whole-body MRI: comparison with bone and 67 Ga scintigraphies

Initial experience with FSE STIR whole-body MR imaging for staging lymphoma in children

Assessing permeability alterations of the blood–bone marrow barrier due to total body irradiation: in vivo quantification with contrast enhanced magnetic resonance imaging

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