Clinical and Prognostic Significance of Femoral Marrow Magnetic Resonance Imaging in Patients With Malignant Lymphoma

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Abstract
We evaluated 56 consecutive patients with newly diagnosed lymphoma including 48 with non-Hodgkin's lymphoma (NHL) and 8 with Hodgkin's disease to determine the clinical and prognostic significance of magnetic resonance imaging (MRI) of the femoral marrow. MR images of the femoral marrow were obtained by the T1-weighted spin echo method and the short TI inversion recovery technique. Abnormal “positive” images were seen in 29 of the 56 patients (52%). All 17 patients with positive biopsy results showed abnormal images on their femoral marrow MRI. Three “positive” MRI patterns — scattered (72%), uniform (21%), and nodular (7%) — were observed. The overall survival of the patients with a positive MRI pattern was significantly poorer than that of patients with a normal pattern (P = .0129). Survival did not differ significantly according to MRI pattern. The 3-year survival rate in the patients with a normal MRI pattern was 89.9% and in the patients with a positive MRI pattern, it was 41.0%. This difference was statistically significant (P = .0279) when we evaluated only the patients with NHL. Patients with positive MRI patterns, but a normal bone marrow histology, showed a significantly shorter survival than those with a normal MRI pattern (P = .016). These results indicate that abnormal MR images of the femoral marrow are associated with a significantly poorer survival in patients with malignant lymphoma, regardless of histologic findings in the marrow.