Femoral marrow MRI is a non-invasive, non-irradiated and useful tool for detecting bone marrow involvement in non-Hodgkin lymphoma

  • Ikeda Shohei
    Department of Hematology, Fukushima Medical University Aizu Medical Center, Aizuwakamatsu, Fukushima, Japan,
  • Tsunoda Saburo
    Department of Hematology, Fukushima Medical University Aizu Medical Center, Aizuwakamatsu, Fukushima, Japan,
  • Koyama Daisuke
    Division of Stem Cell Regulation, Center for Molecular Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan,
  • Suzuki Manabu
    Department of Hematology, Fukushima Medical University Aizu Medical Center, Aizuwakamatsu, Fukushima, Japan,
  • Sukegawa Masumi
    Department of Hematology, Fukushima Medical University Aizu Medical Center, Aizuwakamatsu, Fukushima, Japan,
  • Misawa Kyohei
    Department of Hematology, Juntendo University Shizuoka Hospital, Izunokuni, Shizuoka, Japan,
  • Hojo Hiroshi
    Department of Pathology, Fukushima Medical University Aizu Medical Center, Aizuwakamatsu, Fukushima, Japan,
  • Zhu Xin
    Biomedical Information Engineering Lab, The University of Aizu, Aizuwakamatsu, Fukushima, Japan,
  • Utano Kenichi
    Department of Radiology, Fukushima Medical University Aizu Medical Center, Aizuwakamatsu, Fukushima, Japan
  • Ohta Masatsugu
    Department of Hematology, Fukushima Medical University Aizu Medical Center, Aizuwakamatsu, Fukushima, Japan,

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<p>Femoral marrow magnetic resonance imaging (MRI) is a non-invasive, non-irradiated and useful modality for evaluating bone marrow (BM) conditions. Human adult femoral BM is almost uniformly fatty marrow and has the largest volume of a single bone. MRI has an extremely high resolution for fat and water, which allows high-contrast imaging of cellular infiltration into fat tissue. In hematological diseases, femoral BM MRI can clearly detect cell infiltration, which is symmetrically imaged from the proximal to the distal direction of abnormal signal areas. Thus, we investigated the significance of femoral MRI for non-Hodgkin lymphoma (NHL). We analyzed the data of 69 NHL patients who received femoral MRI at diagnosis in this single-center retrospective cohort study. The median patient age was 73 years. MRI patterns were mainly classified as uniform patterns or nonuniform patterns. We also classified the range of cellular marrow as high-grade or low-grade based on whether it had spread to over half of the femur. Both overall survival (OS) and progression-free survival (PFS) were significantly influenced by abnormal femoral marrow MRI. In particular, the patients with cellular femoral marrow lesions had a worse OS and PFS based on log-rank tests. Multivariable analyses with the Cox proportional hazards model revealed that OS and PFS were significantly influenced by cellular marrow diagnosed by femoral MRI. We concluded that femoral marrow MRI is a useful tool for detecting BM involvement and an independent prognostic factor in NHL patients.</p>

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