Jie C Nguyen1,2, Kirkland W Davis3, Alexandre Arkader4,5, Andressa Guariento6, Alyssa Sze6, Shijie Hong6, Diego Jaramillo7. 1. Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA. nguyenj6@email.chop.edu. 2. Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA. nguyenj6@email.chop.edu. 3. Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. 4. Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA. 5. Divison of Orthopaedic Surgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA. 6. Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA. 7. Department of Radiology, Columbia University Medical Center, New York City, NY, USA.
Abstract
OBJECTIVES: To investigate the prevalence and distribution of specific marrow patterns on pre-treatment magnetic resonance imaging (MRI) examinations in children with leukaemia and lymphoma and with respect to the anatomic location. MATERIALS AND METHODS: This retrospective IRB-approved and HIPAA-compliant study included children with leukaemia or lymphoma who underwent pre-treatment MRI examinations over 18 years (between 1 January 1995 and 31 August 2013). Two radiologists blinded to the clinical diagnosis reviewed each study to determine the presence or absence of abnormal marrow signal and, when present, sub-categorised the pattern into diffuse, patchy, or focal abnormal marrow. Chi-square and Fisher's exact tests were used to compare marrow patterns between leukaemia and lymphoma. RESULTS: The study included 50 children (32 males and 18 females; mean age 9.5 ± 5.3 years) with 54 MRI examinations (27 leukaemia and 27 lymphoma) that included 26 spine and 28 non-spine studies. Marrow replacement was present on 43 (80%) studies, significantly more common with leukaemia than with lymphoma (p = 0.039). The diffuse replacement pattern was significantly more common with leukaemia when compared to lymphoma (p < 0.001) and the focal pattern was only observed with lymphoma. In the spine, the diffuse pattern was observed with lymphoma (3/14, 21%). All patients with leukaemia and MRI outside of the spine showed marrow involvement. CONCLUSION: Marrow replacement is common on MRI from children with leukaemia and lymphoma. A diffuse pattern was significantly associated with leukaemia on studies outside of the spine and a focal pattern was only observed with lymphoma, independently of the anatomic location. KEY POINTS: • Bone marrow replacement on pre-treatment MRI examinations in children with leukaemia and lymphoma was observed in 93% (25/27) and 67% (18/27), respectively. • Diffuse pattern of marrow replacement was significantly more common in leukaemia even though this pattern was also observed with lymphoma on the spine MRI studies. • Focal pattern of marrow replacement was present only with lymphoma and not with leukaemia regardless of the anatomic location.
OBJECTIVES: To investigate the prevalence and distribution of specific marrow patterns on pre-treatment magnetic resonance imaging (MRI) examinations in children with leukaemia and lymphoma and with respect to the anatomic location. MATERIALS AND METHODS: This retrospective IRB-approved and HIPAA-compliant study included children with leukaemia or lymphoma who underwent pre-treatment MRI examinations over 18 years (between 1 January 1995 and 31 August 2013). Two radiologists blinded to the clinical diagnosis reviewed each study to determine the presence or absence of abnormal marrow signal and, when present, sub-categorised the pattern into diffuse, patchy, or focal abnormal marrow. Chi-square and Fisher's exact tests were used to compare marrow patterns between leukaemia and lymphoma. RESULTS: The study included 50 children (32 males and 18 females; mean age 9.5 ± 5.3 years) with 54 MRI examinations (27 leukaemia and 27 lymphoma) that included 26 spine and 28 non-spine studies. Marrow replacement was present on 43 (80%) studies, significantly more common with leukaemia than with lymphoma (p = 0.039). The diffuse replacement pattern was significantly more common with leukaemia when compared to lymphoma (p < 0.001) and the focal pattern was only observed with lymphoma. In the spine, the diffuse pattern was observed with lymphoma (3/14, 21%). All patients with leukaemia and MRI outside of the spine showed marrow involvement. CONCLUSION: Marrow replacement is common on MRI from children with leukaemia and lymphoma. A diffuse pattern was significantly associated with leukaemia on studies outside of the spine and a focal pattern was only observed with lymphoma, independently of the anatomic location. KEY POINTS: • Bone marrow replacement on pre-treatment MRI examinations in children with leukaemia and lymphoma was observed in 93% (25/27) and 67% (18/27), respectively. • Diffuse pattern of marrow replacement was significantly more common in leukaemia even though this pattern was also observed with lymphoma on the spine MRI studies. • Focal pattern of marrow replacement was present only with lymphoma and not with leukaemia regardless of the anatomic location.
Entities:
Keywords:
Bone marrow; Children; Leukaemia; Lymphoma; Magnetic resonance imaging
Authors: Fernando Ruiz Santiago; Antonio Jesús Láinez Ramos-Bossini; Yì Xiáng J Wáng; José Pablo Martínez Barbero; Jade García Espinosa; Alberto Martínez Martínez Journal: Quant Imaging Med Surg Date: 2022-07