[The diagnostic problems in magnetic resonance tomography of the bone marrow in patients with malignomas under G-CSF therapy].
OBJECTIVE
To study the effect of G-CSF therapy directly by MRI and 1H MRS in the lumbar and femoral bone marrow and differentiate between malignant bone marrow infiltration (MBMI) and reconversion of red marrow.


METHODS
Thirteen patients could be examined twice, before and during G-CSF medication and another six only during treatment. T1 weighted spin-echo and opposed-phase gradient-echo images as well as the spectroscopic data (T2 values, water content) were analysed.


RESULTS
After G-CSF a pathologic bone marrow signal intensity was seen in 8/13 (lumbar) and 11/13 (femoral) patients respectively. The majority of the signal alterations were diffuse (6 and 8), the minority focal (2 and 3). If a patient was successfully stimulated, a significant increase in water content occurred (21% lumbar, 34% femoral). T2 values did not change significantly, nor did they correlate with the stimulation success.


CONCLUSIONS
MR tomography and -spectroscopy are suitable to detect lumbar and femoral bone marrow stimulation by G-CSF quantitatively and qualitatively. The changes may simulate MBMI. The adequate judgement of G-CSF treated bone marrow without pretherapeutic images is not possible.
Layer
G
G
Radiologische Universitätsklinik, Bonn. layer@mailer.meb.uni-bonn.de
Sander
W
W
Träber
F
F
Block
W
W
Ko
Y
Y
Ziske
C G
CG
König
R
R
Vahlensieck
M
M
Schild
H H
HH
D000328:Adult; D001853:Bone Marrow / Q000473:pathology*; D019046:Bone Marrow Neoplasms / Q000175:diagnosis / Q000556:secondary; D003937:Diagnosis, Differential; D005260:Female; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D009682:Magnetic Resonance Spectroscopy / Q000379:methods / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis* / Q000188:drug therapy*; D011994:Recombinant Proteins
D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D000069585:Filgrastim