Diagnostic problems of MRI in studying the effect of G-CSF therapy in bonemarrow of patients with malignoma

Aim. To study the effect of G-CSF therapy directly by MRI and H-1 MRS in th e lumbar and femoral bone marrow and differentiate between malignant bone m arrow infiltration (MBMI) and reconversion of red marrow. Methods. Thirteen patients could be examined twice, before and during G-CSF medicatio and another six only during treatment. T1 weighted spin-echo and opposed-phase gradient-echo images as well as the spectroscopic data (T2 v alues, water content) were analysed. Results. After G-CSF a pathologic bone marrow signal intensity was seen in 8/13 (lumbar) and 11/13(femoral) patients respectively. The majority of the signal alterations were diffuse (6 and 8),the minority focal (2 and 3). If a patient was successfully stimulated, a significant increase in water con tent occured (21% lumbar, 34% femoral). T2 values did not change significan tly, nor did they correlate with the stimulation success. Conclusions. MR tomography and -spectroscopy are suitable to detect lumbar and femoral bone marrow stimulation by G-CSF quantitatively and qualitative ly. The changes may simulate MBMI. The adequate judgement of G-CSF treated bone marrow without pretherapeutic images is not possible.