A. Varan et al., Prognostic importance of magnetic resonance imaging in bone marrow involvement of Hodgkin disease, MED PED ONC, 32(4), 1999, pp. 267-271
Background, Determination of bone marrow involvement is important in stagin
g Hodgkin disease (HD), so Lye compared the effectiveness of magnetic reson
ance imaging (MRI) with bone marrow biopsy in diagnosing bone marrow involv
ement in HD patients. Procedure, Twenty-six patients with the diagnosis of
HD were included in this study. The ages of the patients were between 4 and
24 years, with a median of 12. Eleven of them had stage III or IV disease
and 15 had been previously diagnosed as having HD and were in relapse. They
were evaluated by bone marrow biopsy and MRI of lumbar vertebrae. The biop
sies were taken from the anterosuperior iliac spine with an age-appropriate
Jamshidi biopsy needle. Within 14 days following biopsy, MRI of lumbar ver
tebrae was carried out. Results. MRI revealed decreased signal intensity in
T1-weighted images in 7 of 26 patients. On the other hand, bone marrow bio
psies showed HD involvement in three out of seven patients. The remaining 1
9 patients who had normal bone MRI were negative for HD in their bone marro
w biopsies. The patients with positive MRIs and negative biopsy for HD had
bone pain. One of them had a femoral periosteal reaction on bone survey; th
e other two had height loss in their lumbar vertebral bodies. There was a s
tatistically significant difference in the disease-free survival rates betw
een MRI-positive and -negative patients in the following 24 months period (
P < 0.0001). Conclusions. This study suggests that MRI is a useful method f
or diagnosing bone marrow involvement in HD, in that our MRI-positive patie
nts had a higher relapse rate in the 24 months follow-up period than the MR
I-negative patients. Med. Pediatr. Oncol. 32:267-271, 1999. (C) 1999 Wiley-
Liss, Inc.