Title:The Diagnostic Value of Abnormal Bone Marrow Signal Changes on Magnetic
Resonance Imaging: Is Bone Marrow Biopsy Essential?
Volume: 20
Author(s): Fatma Arikan*, Yasin Yildiz, Rabia Ergelen, Isık Atagündüz and Tayfur Toptas
Affiliation:
- Department of Hematology, Marmara University Hospital, Istanbul, Turkey
Keywords:
Bone marrow, Signal changes, Magnetic resonance imaging, Hematologic malignancy, Patients, Clinical.
Abstract:
Background:
It is essential to determine whether bone marrow signal changes on magnetic resonance imaging (MRI) represent a physiological response or
pathology; at present, the clinical significance of these signal changes is unclear. It is unknown whether a bone marrow biopsy is required when
bone marrow signal changes are detected incidentally in individuals without suspected malignancy.
Objective:
The primary purpose of this study was to determine whether incidentally detected bone marrow signal changes on MRI performed for various
reasons (at the time of admission or during follow-up) are clinically significant.
Methods:
We retrospectively evaluated the bone marrow biopsy clinical and laboratory findings of 42 patients with incidental bone marrow signal changes
on MRI between September 2016 and January 2020. We also determined whether the patients were diagnosed with malignancy during admission
or follow-up.
Results:
Of the 42 patients, three (7%) were diagnosed with hematological malignancies during admission, while two were diagnosed with multiple
myeloma and one with B-cell acute lymphoblastic leukemia. Of the 42 patients, 35 had a mean follow-up of 40.6 ± 5.3 months. One patient was
diagnosed with monoclonal gammopathy of undetermined significance four months after their first admission.
Conclusions:
In addition to MRI, detailed clinical and laboratory evaluations should be performed to inform the decision for bone marrow biopsy and exclude
hematological malignancy. If there is any doubt, a bone marrow biopsy should be performed. Moreover, since bone marrow signal changes may be
a preliminary finding, follow-up of these patients is essential.
