Distinguishing Imaging Features between Spinal Hyperplastic Hematopoietic Bone Marrow and Bone Metastasis

Abstract

BACKGROUND AND PURPOSE: Systematic investigations of the distinguishing imaging features between spinal hyperplastic hematopoietic bone marrow and bone metastasis have not been reported, to our knowledge. The purpose of this study was to determine the distinguishing imaging features of the 2 entities.

Differentiation of focal indeterminate marrow abnormalities with multiparametric MRI

“…The prior studies described that red‐marrow hyperplasia, on conventional imaging, shows moderate to marked decrease in signal intensity on T 1 ‐ and T 2 ‐weighted spin‐echo images. Moreover, they showed mild‐to‐moderate increases in signal intensity on fat‐saturated T 2 ‐weighted images compared to malignancy . In contrast, our results show that the conventional imaging findings including signal intensity of the lesions on T 1 ‐ and fat‐suppressed T 2 ‐weighted images, margin, and enhancement pattern do not differ in either group.…”

“…Therefore, the exact diagnosis is often delayed until pathology is confirmed, or stability of the lesion is proven on follow‐up exams. In a recent study, PET‐CT demonstrated significant differences in FDG uptakes between the spinal hyperplasic hematopoietic marrow and bone metastasis . However, 5 out of 13 cases with metastasis had a similar range of maximum standardized uptake value to that of hematopoietic marrow in the study.…”

“…However, signal changes caused by benign processes such as red‐marrow hyperplasia, degenerative marrow change, insufficiency fracture, or infection can be similar to those of malignant infiltration . Various MRI techniques including chemical‐shift imaging, dynamic contrast‐enhanced imaging (DCE), and diffusion‐weighted imaging (DWI) have been studied for differentiating benign and malignant marrow lesions . Most of the prior studies demonstrated promising results in discriminating the two entities.…”

Machine Learning for Diagnosis of Hematologic Diseases in Magnetic Resonance Imaging of Lumbar Spines

“…The use of intervertebral disks or skeletal muscle signals in T1-weighted images has been internal standards in clinical practice since the initial study reported that they have helped determine pathologic marrow infiltrations with high accuracy 15 . However, the challenge for diagnosing marrow infiltrative diseases has been attributed to the presence of an overlap between normal hypercellular marrow and diffuse marrow infiltrations 16 . Moreover, a considerable proportion of multiple myeloma and the most of MGUS have been deluded as normal marrow patterns 17,18 .…”

Esophageal Cancer with Bone Marrow Hyperplasia Mimicking Bone Metastasis: Report of a Case

“…Shigematsu et al [9] demonstrated the imaging features of bone marrow hyperplasia and bone metastasis. Their quantitative study showed that mean maximum SUV (SUV max ) for bone marrow hyperplasia was significantly lower than that for bone metastasis, and indicated that quantitative assessment using SUV max >3.6 is useful for differentiating bone marrow hyperplasia from bone metastasis.…”