Magnetic Resonance Imaging of the Bone Marrow in Patients with Acute Leukemia during and after Chemotherapy Changes in T1 Relaxation

Abstract

Twenty-seven patients with acute leukemia were examined at the time of diagnosis with MR imaging and in vivo T1 relaxation time measurements of the hemopoietic bone marrow. A 1.5 T whole body magnetic resonance scanner was used. Twenty of the patients had follow-up examinations in relation to chemotherapy. Bone marrow biopsies from the posterior iliac crest were obtained within a short time interval of all MR examinations. At the time of diagnosis, TI relaxation times were increased significantly in all the leukemic patients, compared with 24 age-matched controls. A decrease in TI relaxation time towards or into the normal range was observed in 10 patients who obtained remission. The TI relaxation time remained prolonged in 6 patients who failed to obtain remission during chemotherapy. Four patients, who obtained remission with concomitant decrease of TI values towards or into the normal range, also showed prolongation ofTI relaxation time in relation to leukemic relapse. The results indicate that changes observed in TI relaxation times of the hemopoietic bone marrow in patients with acute leukemia reflect changes in disease activity, and, that serial measurements of TI values may provide clinically useful information with the possibility for identification of residual disease in regions inaccessible for biopsy.

Magnetic resonance imaging of femoral marrow predicts outcome in adult patients with acute myeloid leukaemia in complete remission

“…Most patients with untreated acute leukaemia demonstrate distinctive abnormalities on MR images of the BM (Takagi et al , 1995; Vande Berg et al , 1996). T1 relaxation times of marrow are prolonged at the time of diagnosis of leukaemia (Thomsen et al , 1987; Richards et al , 1988; Jensen et al , 1990a,b; Vande Berg et al , 1996). After successful chemotherapy, such MR abnormalities usually yield to a normal marrow pattern (Takagi et al , 1995; Vande Berg et al , 1996), with T1 relaxation times approaching or entering the normal range (Thomsen et al , 1987; Richards et al , 1988; Jensen et al , 1990a,b).…”

Prolonged T1 Relaxation of the Hemopoietic Bone Marrow in Patients with Chronic Leukemia

“…Infiltrative bone marrow disease, such as leukemia, increases marrow cellularity and 'water' content, and this affects the Tl relaxation process. Previous studies from our group have shown prolonged Tl relaxation times for the bone marrow in patients with: polycythemia (I), preleukemia (2) and acute leukemia (3,4,18) at the time of diagnosis.…”

“…We have previously reported prolonged T1 relaxation times in patients with acute leukemia-in adults (3,18) as well as in children (4). In the present study, we found in-The Tl relaxation times of the vertebral bone marrow in patients with chronic lymphocytic leukemia (CLL) and chronic myeloid leukemia (CML) are given at the time of diagnosis.…”

“…These 8 patients were examined with identical methods (1), and they showed prolongation in T1 relaxation time in the same order of magnitude as the patients with chronic leukemia. Prolonged TI values have, furthermore, been reported in preleukemia (2), as well as in acute leukemia (3,18): this suggests a rather low specificity for MR imaging with regard to diagnostic potential. In the present study, no differences in TI relaxation times were found between CLL and CML, in spite of the marked differences between bone marrow cell populations with regard to cell type, cellular differentiation and turn-over rate.…”

“…The procedures and methods have been described in detail in previous reports (2,3,18). Precision and accuracy of the TI relaxation time measurements were estimated on a reference phantom (standard test object No.…”