Assessment of the composition of bone marrow prior to and following autologous BMT and PBSCT by magnetic resonance

Abstract

Lumbar bone marrow was assessed by means of magnetic resonance (MR) in 23 examinations of eight patients who underwent autologous bone marrow transplantation (ABMT) or peripheral blood stem cell transplantation (PBSCT). Various imaging and spectroscopic techniques were applied for measurements carried out prior to conditioning for ABMT/PBSCT and in the course of reconstitution and correlated with clinical and blood chemistry data in these patients. The signal intensity from lumbar bone marrow was determined in T1-weighted and water- and fat-selective MR images. The distribution of the magnetic field was demonstrated by a field-mapping method. Localized proton spectroscopy was performed from volume elements of 2 ml located in the central region of vertebral bodies in order to evaluate the fraction of the water signals, the transverse relaxation times T2 of the signals from water and lipids, and the line widths of the spectral signals. Regions of bone marrow after inflammatory conditions or intensive irradiation are shown to be not involved in marrow reconstitution. Additional information about marrow composition was obtained by the magnetic field mapping and by the line widths in the spectra. Considerable alterations of the amount of paramagnetic hemosiderin were revealed following transplantation. Patients with low water signal and strong local inhomogeneities of the magnetic field in the marrow prior to transplantation had a delayed hematopoietic reconstitution compared with the patients lacking these MR features.

3-Tesla MR spectroscopy in patients subjected to bone marrow transplantation: clinical correlations

“…Uno studio condotto da Schick et al [6] asserisce che lo studio con RM del rachide lombo-sacrale, in contrasto con le tecniche bioptiche che dimostrano solo la composizione locale del midollo osseo, permette sia una caratterizzazione della composizione del midollo osseo emopoietico che una stima della distribuzione spaziale di acqua e lipidi, consentendo quindi una valutazione globale non invasiva del midollo osseo e forings of the two observers was -1.2%±4.2% with 95% limits of agreement, as estimated according to the Bland-Altman method (Fig. 6), between -9.42% and 7.03%.…”

“…A study conducted by Schick et al [6] states that MR imaging of the lumbosacral spine, in contrast to biopsy techniques that demonstrate only the local composition of the bone marrow, provides both a characterisation of the composition of the haematopoietic bone marrow and an estimation of the spatial distribution of water and fat, thereby enabling a global and noninvasive evaluation of the bone marrow and providing important additional nendo delle informazioni cliniche aggiuntive rilevanti [6] [6]. In fact, clinical and laboratory data -despite being abnormal in the event of blood and lymph node diseases -always need to be complemented with bone marrow aspiration or core biopsy in order to reach a definite diagnosis.…”

“…Pertanto, il monitoraggio della ripresa midollare del paziente nel periodo successivo al TMO rappresenta un momento essenziale nella gestione di questi pazienti [6,7] [6].…”

“…Magnetic resonance (MR) spectroscopy of the bone marrow, correlated with the pre-and posttransplant blood parameters, can provide information on the composition and possible physiological and pathological changes in vertebrae bone marrow before, during and after treatment. In parallel, MR study can confirm whether or not a local biopsy is truly representative of bone marrow status [6].…”

“…Monitoring marrow recovery following BMT is therefore an essential step in managing these patients [6,7] and is usually done with a full blood count on peripheral blood, iliac crest biopsy and bone marrow aspiration. However, in addition to being invasive and painful, the latter procedures are carried out on a single location and therefore often fail to provide information regarding the entire haematopoietic system and cellularity and composition of the bone marrow.…”