Chronic lymphocytic leukemia: Changes in bone marrow composition and distribution assessed with quantitative MRI

The purposes of this study were (a) to determine the prevalence of bone mar row abnormalities in patients with chronic lymphocytic leukemia (CLL) using quantitative MR assessment of axial marrow composition and peripheral marr ow distribution; (b) to assess the agreement between both quantitative MR m ethods and compare their sensitivities to detect marrow alterations; and (c ) to correlate MR findings with clinical and laboratory parameters. Twenty- nine consecutive patients with biopsy-proven CLL were investigated on a .5- T MR imager to determine bulk T1 relaxation times of the vertebral bone mar row and proportion of proximal femur surface area occupied by nonfatty marr ow on coronal T1-weighted MR images of one hip. Of the 29 patients, 12 (41% ) had abnormal increase in lumbar marrow T1 values (>600 msec) and 16 (55%) had increased proportion of surface area occupied by nonfatty marrow in th e proximal femur (>+1 SD compared to normal values determined in sex- and a ge-matched healthy subjects). The results of both quantitative MR methods w ere normal in 12 patients and abnormal in 11 patients (agreement, 79%). Pat ients with alterations in peripheral marrow distribution had significantly higher T1 relaxation times (P = .001) than those with normal peripheral mar row. Patients with abnormal marrow composition or distribution at MRI had s ignificantly higher blood and marrow lymphocytosis than patients without th ese features. In conclusion, the agreement between both quantitative MR met hods suggests a parallelism between changes in axial marrow composition and in peripheral marrow distribution in patients with CLL. The limits of quan titative MRI in CLL must be kept in mind, because quantitative MR methods f ailed to detect leukemic marrow infiltration in 41% of patients.