title: Quantitative and semiquantitative evaluation of erythropoietin-induced bone marrow signal changes in lumbar spine MRI in patients with tumor anemia.
abstract: BACKGROUND
  The topic of this article is the quantitative and semiquantitative assessment of bone marrow signal alteration in magnetic resonance imaging (MRI) of the lumbar spine in patients with tumor anemia during therapy with epoietin beta or placebo.
  
  
  METHODS
  We examined 32 patients with head or neck cancer (16 epoietin beta, 16 placebo) during radiotherapy in a double-blind multicenter trial. During radiotherapy, the patients underwent epoietin beta therapy for 7-9 weeks. Lumbar spine measurements using T1-w SE, OPP and Turbo- STIR were taken prior to the first epoietin beta or placebo therapy, after the acquired hemoglobin level had been reached, and after the final radiotherapy. The semiquantitative assessment was made blinded by 2 independent radiologists.
  
  
  RESULTS
  We found significant differences between both groups. The first MRI showed normal marrow signals. The second MRI revealed a quantified decrease in bone marrow signal in T1-w SE (p < 0.018) and an increase in OPP (p < 0.01) and Turbo-TIR (p < 0.048) sequences. At the third MR imaging, quantified relative marrow signals returned to baseline level in all sequences. Semiquantitative assessment confirmed these results.
  
  
  CONCLUSIONS
  In both analyses, lumbar spine MRI demonstrates significant bone marrow changes in T1-w SE, OPP and Turbo-STIR sequences during epoietin beta therapy.
authors.affiliation: Department of Diagnostic Radiology, University Hospital Freiburg, Germany. nadir.ghanem@uniklinik-freiburg.de
authors.forename: Nadir
authors.initials: N
authors.lastname: Ghanem
authors.forename: Anna
authors.initials: A
authors.lastname: Lerche
authors.forename: Christian
authors.initials: C
authors.lastname: Lohrmann
authors.forename: Carsten
authors.initials: C
authors.lastname: Altehoefer
authors.forename: Michael
authors.initials: M
authors.lastname: Henke
authors.forename: Mathias
authors.initials: M
authors.lastname: Langer
mesh_terms: D000328:Adult; D000368:Aged; D000740:Anemia / Q000175:diagnosis / Q000188:drug therapy*; D001853:Bone Marrow / Q000187:drug effects* / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy*; D004311:Double-Blind Method; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006400:Hematocrit; D006452:Hemoglobinometry; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008159:Lumbar Vertebrae / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010039:Otorhinolaryngologic Neoplasms / Q000532:radiotherapy*
chemical_list: D004921:Erythropoietin