Potential prognostic implications of whole-body bone marrow MRI in diffuse large B-cell lymphoma patients with a negative blind bone marrow biopsy

J Magn Reson Imaging. 2014 Jun;39(6):1394-400. doi: 10.1002/jmri.24318. Epub 2013 Nov 14.

Abstract

Purpose: To assess the prognostic implications of whole-body bone marrow MRI findings in diffuse large B-cell lymphoma (DLBCL) patients with a negative blind bone marrow biopsy (BMB).

Materials and methods: Thirty-eight patients with newly diagnosed DLBCL and negative blind BMB prospectively underwent whole-body MRI (T1-weighted, T2-weighted short inversion time inversion recovery, and diffusion-weighted sequences), which were scored as positive or negative for lymphomatous bone marrow involvement. Proportions of patients who experienced disease relapse/progression or died during follow-up were calculated and compared between whole-body MRI-positive and whole-body MRI-negative patients.

Results: The median follow-up time of surviving patients was 973 days (range, 391-1655 days). Disease relapse/progression occurred in 33% (5/15) of patients with a positive whole-body MRI and in 13% (3/23) of patients with a negative whole-body MRI. In addition, 20% (3/15) of patients with a positive whole-body MRI died during follow-up, compared with 9% (2/23) of patients with a negative whole-body MRI.

Conclusion: The results of this study show that disease relapse or progression and death may occur more frequently in whole-body MRI-positive patients than in whole-body MRI-negative patients, which suggests that whole-body bone marrow MRI findings in DLBCL patients with a negative BMB may have prognostic implications.

Keywords: bone marrow biopsy; diffuse large B-cell lymphoma; prognosis; whole-body MRI.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Biopsy
  • Bone Marrow / pathology*
  • Child
  • Diffusion Magnetic Resonance Imaging / methods
  • Female
  • Follow-Up Studies
  • Humans
  • Image Processing, Computer-Assisted / methods
  • Lymphoma, Large B-Cell, Diffuse / diagnosis*
  • Lymphoma, Large B-Cell, Diffuse / pathology
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / diagnosis*
  • Neoplasm Recurrence, Local / pathology
  • Prognosis
  • Prospective Studies
  • Survival Analysis
  • Whole Body Imaging / methods*
  • Young Adult