Prognostic significance of magnetic resonance imaging of femoral marrow inpatients with myelodysplastic syndromes

Purpose: to investigate whether the abnormalities observed on femoral marro w magnetic resonance images are related to the development of leukemia and survival of patients with myelodysplastic syndromes (MDS). Patients and Methods: The findings on magnetic resonance images of the femo ral marrow were evaluated over periods of 1 to 92 months (median, 18 months ) in 42 consecutive adult patients with newly diagnosed MDS. Magnetic reson ance images were obtained by the T1-weighted spin echo method and the short TI inversion recovery technique, Results: Magnetic resonance images showed that the femoral marrow patterns changed from fatty, faint, or nodular to scattered or uniform as the diseas e progressed, Development of acute myeloid leukemia was observed in only 13 patients whose marrow exhibited a scattered or uniform pattern. The overal l survival of the 29 patients with a scattered or uniform marrow pattern wa s significantly shorter than that of the 13 patients with a fatty, faint, o r nodular marrow pattern (10.7% v 73.3% at 7 years; P < .01). The period of leukemia-free survival was also significantly shorter in the patients with a scattered or uniform marrow pattern versus a fatty, faint, or nodular pa ttern (37.7% v 100% at 7 years; P < .01). Conclusion: Magnetic resonance images of the femoral marrow can provide val uable information for assessing the prognosis and determining the most appr opriate management of patients with MDS. J Clin Oncol 17:277-283. (C) 1999 by American Society of Clinical Oncology.