Abnormal bone marrow signal on MRI heralding oncologic diagnoses: A single institution review.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 1580-1580
Author(s):  
Gunjan L. Shah ◽  
Jamie Michelle Bunch Jarboe ◽  
Aaron Seth Rosenberg ◽  
Andreas Kirschmer Klein ◽  
Furha Iram Cossor
Keyword(s):  
Bone Marrow ◽  
Medical Center ◽  
Final Diagnosis ◽  
Peripheral Blood Flow ◽  
Bone Marrow Signal ◽  
Radiology Reports ◽  
Abnormal Bone Marrow ◽  
Magnetic Resonance Imaging Mri ◽  
Marrow Signal

1580 Background: The increased use of magnetic resonance imaging (MRI) has resulted in increased numbers of incidental findings. Oncologists often receive consults for workup of "abnormal marrow signal." As there is no standard evaluation for such findings and the yield of additional evaluation is unclear, we performed a retrospective study of patients evaluated with MRI at Tufts Medical Center (TMC). Methods: With IRB approval, TMC radiology reports were searched from 5/9/05-12/31/08 with GE Centricity Radiology Information System 2.2. Included patients had MRI reports containing the phrases “abnormal bone marrow” or “heterogeneous bone marrow”, but no clear etiology stated. Further workup, including referral to a subspecialist, laboratory, radiographic, or pathologic evaluations, final diagnosis, and last follow up were collected. Results: 29,508 MRIs were performed and 77 patients met search criteria. Median age was 58 years with a median follow-up of 41 months at TMC after qualifying MRI. 40/77 (52%) of patients had either an MRI of the lumbar spine or hip with 21/77 (27%) undergoing work-up for the marrow findings. Evaluations included CBC (38%), SPEP (24%), quantitative immunoglobulins (14%), free light chains (10%), peripheral blood flow cytometry (5%), bone marrow biopsy (19%), skeletal survey (14%), bone scan (48%), CT scan (24%), biopsy of other site (24%), and subspecialty referal (48%, 29% to oncology). Definitive diagnosis was assigned in 11/21 (52%) cases, with 5 being malignancies (1 follicular lymphoma, 2 multiple myeloma, 2 lung cancer). Three patients were later diagnosed with malignancy (breast cancer, myelodysplastic syndrome, merkel cell carcinoma) at a median of 19 months. Overall, 10% of patients with abnormal marrow on MRI were diagnosed with a malignancy. Conclusions: Incidentally noted abnormal or heterogeneous bone marrow signal on MRI was not inconsequential. Of those patients who underwent evaluation for the finding, 24% were diagnosed with a malignancy. We conclude that abnormal bone marrow findings on MRI should not be ignored, and given the rates of malignancy in our series, oncologists are ideally suited for this task.

scholarly journals Incidence and Evaluation of Incidental Abnormal Bone Marrow Signal on Magnetic Resonance Imaging

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Gunjan L. Shah ◽  
Aaron S. Rosenberg ◽  
Jamie Jarboe ◽  
Andreas Klein ◽  
Furha Cossor
Keyword(s):  
Magnetic Resonance Imaging ◽  
Bone Marrow ◽  
Magnetic Resonance ◽  
Complete Blood Count ◽  
Medical Center ◽  
Resonance Imaging ◽  
Bone Marrow Signal ◽  
Abnormal Bone Marrow ◽  
Marrow Signal

Purpose. The increased use of magnetic resonance imaging (MRI) has resulted in reports of incidental abnormal bone marrow (BM) signal. Our goal was to determine the evaluation of an incidental abnormal BM signal on MRI and the prevalence of a subsequent oncologic diagnosis.Methods. We conducted a retrospective cohort study of patients over age 18 undergoing MRI between May 2005 and October 2010 at Tufts Medical Center (TMC) with follow-up through November 2013. The electronic medical record was queried to determine imaging site, reason for scan, evaluation following radiology report, and final diagnosis.Results. 49,678 MRIs were done with 110 patients meeting inclusion criteria. Twenty two percent underwent some evaluation, most commonly a complete blood count, serum protein electrophoresis, or bone scan. With median follow-up of 41 months, 6% of patients were diagnosed with malignancies including multiple myeloma, non-Hodgkins lymphoma, metastatic non-small cell lung cancer, and metastatic adenocarcinoma. One patient who had not undergone evaluation developed breast cancer 24 months after the MRI.Conclusions. Incidentally noted abnormal or heterogeneous bone marrow signal on MRI was not inconsequential and should prompt further evaluation.

Involvement of the proximal tibiofibular joint in ankylosing spondylitis

2009 ◽  
Vol 50 (4) ◽  
pp. 418-422 ◽  
Author(s):  
Hyun Pyo Hong ◽  
Hye Won Chung ◽  
Byeong-Kyoo Choi ◽  
Young Cheol Yoon ◽  
Sang Hee Choi
Keyword(s):  
Bone Marrow ◽  
Lumbar Spine ◽  
Ankylosing Spondylitis ◽  
Signal Intensity ◽  
Proximal Tibiofibular Joint ◽  
Plain Radiographs ◽  
Bone Marrow Signal ◽  
Abnormal Bone Marrow ◽  
Marrow Signal ◽  
Subchondral Sclerosis

Background: Ankylosing spondylitis (AS) may affect peripheral joints, with the shoulder, hip, and knee being well known involved sites. However, involvement of the proximal tibiofibular (PTF) joint has not yet been investigated. Purpose: To evaluate PTF joint abnormalities in patients with AS. Material and Methods: From July 1997 to June 2005, 16 patients (15 male, one female; mean age 25 years), who were clinically diagnosed with AS, underwent magnetic resonance imaging (MRI) to evaluate knee pain. All patients also underwent plain radiographs of the knee, lumbar spine, and pelvis. Twenty knee MRIs (bilateral in four patients) and 16 sets of knee, lumbar spine, and pelvic radiographs were retrospectively reviewed in order to evaluate possible AS involvement. The presence of abnormalities suggesting AS involvement were recorded separately in the sacroiliac joints, lumbar spine, hip, and femorotibial and PTF joints. If the PTF joint showed any pathologic findings, the radiologic findings were recorded. Results: Three of 16 patients (18.7%) had pathologic features of the PTF joint observed by plain radiographs or MRI. One of these three patients showed bilateral involvement of the PTF joints on plain radiographs, while the other two patients showed unilateral involvement on MRI. Subchondral sclerosis, cartilage abnormality, erosion, and abnormal bone marrow signal intensity were identified on MRI. Plain radiographs of two patients revealed subchondral sclerosis and spur formation in the PTF joint. The frequencies of involvement of other joints in the 16 patients were as follows: lumbar spine, n=5 (31%), hip joint, n=1 (6%) (identified by plain radiographs), and femorotibial joints, n=10 (62.5%) (identified by knee MRI). Conclusion: MR imaging of the PTF joint can depict synovial changes and their effect on joint structures in patients with AS. The MRI findings of AS involving the PTF joints are subchondral sclerosis, cartilage abnormality, erosion, and abnormal bone marrow signal intensity.

scholarly journals The Prediction of Lymphohematopoietic Diseases by Incidentally-Detected Diffuse Signal Alterations of Bone Marrow on MRI

Acta Medica ◽  
2020 ◽  
Vol 51 (4) ◽  
pp. 48-53
Author(s):  
Rafiye Ciftciler ◽  
Kader Karlı Oguz ◽  
Yahya Buyukasik
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Myeloma ◽  
Bone Marrow ◽  
Magnetic Resonance ◽  
Imaging Techniques ◽  
Resonance Imaging ◽  
Bone Marrow Signal ◽  
Time Of Presentation ◽  
Marrow Signal

Objective: Advanced imaging techniques are increasingly used in the diagnostic workup of patients. The clinical significance of incidentally-detected signal alterations of the bone marrow on magnetic resonance imaging has not been widely studied. The purpose of this study was to determine whether bone marrow signal changing on magnetic resonance imaging could predict a hematologic disease. Materials and Methods: Thirty patients who were referred to Hematology department due to bone marrow signal alteration on magnetic resonance imaging between the years of 2011 and 2018 were evaluated. Results: There were 8 males and 22 females with a median age of 53 (range, 31–86) years at the time of presentation to the Hematology clinic. The magnetic resonance imaging studies had been taken because the patients had complaints of pain in extremities or lumbago (80%). The patients had been followed for median 4.5 months (0-71.7). Six (20%) cases had a bone marrow biopsy at presentation and a diagnosis was established in 5 (16.6%) of them (1 patient was diagnosed acute myeloid leukemia, 4 patients were diagnosed multiple myeloma). Marrow biopsy was done in 11 of the cases during follow-up median 3.8 months (1.3-11.5) after presentation. A diagnosis was made in 9 cases (5 patients were diagnosed multiple myeloma, 2 patients were diagnosed follicular lymphoma, 1 patient was diagnosed waldenstrom macroglobulinemia). Thirteen cases never had a biopsy. These cases had been followed for 1.3 months (0-71.7). None of them showed clinical abnormalities related to a lymphohematopoietic disorder and/or diagnosed with such a disorder. Only 1 patient was diagnosed with osteomalacia at follow-up. Conclusion: Incidentally-detected signal alterations of the bone marrow on magnetic resonance imaging should trigger investigations for a marrow problem. Most of the diagnosis patients were multiple myeloma. Extremity pain and findings like anemia may be associated with lymphohematological malignancies.

Abnormal Bone Marrow Signal Intensity in the Phalanges of the Foot as a Manifestation of Raynaud Phenomenon: A Report of Six Patients

2016 ◽  
Vol 207 (6) ◽  
pp. 1252-1256 ◽  
Author(s):  
Edward Smitaman ◽  
Bruno P. G. Pereira ◽  
Brady K. Huang ◽  
Mina M. Zakhary ◽  
Evelyne Fliszar ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Signal Intensity ◽  
Raynaud Phenomenon ◽  
Bone Marrow Signal ◽  
Abnormal Bone Marrow ◽  
Marrow Signal

scholarly journals Musculoskeletal Soft-Tissue Sarcoma: Quality Assessment of Initial MRI Reports Shows Frequent Deviation from ESSR Guidelines

Diagnostics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 695
Author(s):  
Sebastian Weiss ◽  
Alexander Korthaus ◽  
Nora Baumann ◽  
Jin Yamamura ◽  
Alexander S. Spiro ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcomas ◽  
Quality Criteria ◽  
Final Diagnosis ◽  
Tissue Mass ◽  
Musculoskeletal Radiology ◽  
Radiology Reports ◽  
Patients At Risk ◽  
Magnetic Resonance Imaging Mri ◽  
The Masses

Soft-tissue sarcomas (STS) are a rare subtype of soft-tissue mass and are frequently misinterpreted as benign lesions. Magnetic resonance imaging (MRI) is the primary recommended type of diagnostics. To assess the quality of primary radiology reports, we investigated whether recommended MRI report elements were included in compliance with European Society of Musculoskeletal Radiology (ESSR) guidelines. A total of 1107 patients were evaluated retrospectively, and 126 radiological reports on patients with malignant STS were assessed for ESSR quality criteria. One or more required sequences or planes were missing in 67% of the reports. In all 126 cases, the report recognized the mass as anomalous (100%). Sixty-eight percent of the reports mentioned signs of malignancy. The majority of reports (n = 109, 87%) articulated a suspected diagnosis, 32 of which showed a mismatch with the final diagnosis (25%). Thirty-two percent of the reports had a misinterpretation of the masses as benign. Benign misinterpretations were more common in masses smaller than 5 cm (65% vs. 27%). Thirty percent of the reports suggested tissue biopsy and 6% recommended referral to a sarcoma center. MRI reports showed frequent deviations from ESSR guidelines, and protocol guidelines were not routinely met. Deviations from standard protocol and reporting guidelines could put patients at risk for inadequate therapy.

scholarly journals Bone marrow abnormalities detected by magnetic resonance imaging as initial sign of hematologic malignancies

2018 ◽  
Author(s):  
Ida Sofie Grønningsæter ◽  
Aymen Bushra Ahmed ◽  
Nils Vetti ◽  
Silje Johansen ◽  
Øystein Bruserud ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Bone Marrow ◽  
Magnetic Resonance ◽  
Case Reports ◽  
Cell Types ◽  
Hematologic Malignancies ◽  
Resonance Imaging ◽  
Initial Sign ◽  
Magnetic Resonance Imaging Mri

The increasing use of radiological examination, especially magnetic resonance imaging (MRI), will probably increase the risk of unintended discovery of bone marrow abnormalities in patients where a hematologic disease would not be expected. In this paper we present four patients with different hematologic malignancies of nonplasma cell types. In all patients the MRI bone marrow abnormalities represent an initial presentation of the disease. These case reports illustrate the importance of a careful diagnostic follow-up without delay of patients with MRI bone marrow abnormalities, because such abnormalities can represent the first sign of both acute promyelocytic leukemia as well as other variants of acute leukemia.

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