[MR tomography of the bone marrow changes after high-dosage chemotherapy and autologous peripheral stem-cell transplantation].
OBJECTIVE
Evaluation of MR standard imaging and short time inversion recovery (STIR) imaging to assess changes in red bone marrow cellularity after high-dose chemotherapy (HDC) and peripheral blood stem cells transplantation (PBSCT).


METHODS
Sixty-one magnetic resonance (MR) studies were performed in 15 patients (8 female and 7 male, average age 45 years) who received HDC and PBSCT for therapy of either a solid tumor or multiple myeloma. All patients underwent MR examinations of the lumbar region and both femora with T1- and T2-weighted turbo spin-echo (TSE) and STIR sequences at predefined time intervals. Qualitative analysis of the signal intensity was performed by consensus reading of four radiologists. MR results were correlated with results of blood smears and marrow histology.


RESULTS
STIR sequences demonstrated marked changes in signal intensity not only until the aplasia occurred but also during bone marrow repopulation. An increased signal intensity was observed after HDC in 13/15 patients (87%), followed by a decrease in signal intensity immediately after aplasia in 14/15 patients (93%). Signal intensity further changed parallel to marrow engraftment in 11/15 patients (73%). T2-TSE only showed clear changes during repopulation in 8/15 patients (53%). The individual course of the signal in T1-TSE was markedly inhomogeneous.


CONCLUSIONS
STIR sequences show bone marrow edema during aplasia and marrow cellularity during reconstitution and are suitable for characterisation of red bone marrow after HDC and autologous PBSCT.
Pereira
P L
PL
Abteilung für Radiologische Diagnostik, Eberhard-Karls-Universität Tübingen. philippe.pereira@med.uni-tuebingen.de
Schick
F
F
Einsele
H
H
Farnsworth
C T
CT
Kollmansberger
C
C
Mattke
A
A
Duda
S H
SH
Claussen
C D
CD
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D001853:Bone Marrow / Q000187:drug effects* / Q000473:pathology*; D003131:Combined Modality Therapy; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000473:pathology / Q000628:therapy; D015588:Observer Variation; D011446:Prospective Studies; D013997:Time Factors