title: Osteonecrosis detected by whole body magnetic resonance in patients with Hodgkin Lymphoma treated by BEACOPP.
abstract: OBJECTIVE
  The purpose of our retrospective review of prospectively acquired Whole Body Magnetic Resonance (WB-MRI) scans was to assess the incidence of osteonecrosis in patients who received different chemotherapies.
  
  
  METHODS
  We evaluated the WB-MRI scans performed on 42 patients with Hodgkin Lymphoma treated by three chemotherapy regimens (6ABVD, 2ABVD + 4BEACOPP, 2ABVD + 8BEACOPP), excluding patients with the main risk factors for osteonecrosis.
  
  
  RESULTS
  Six out of seven patients (86 %) who received eight BEACOPP and one out of five patients (20 %) treated by four BEACOPP presented osteonecrosis, with a statistically significant difference of frequency between the two groups of patients (p < 0.05); no injury has been reported in patients treated by only ABVD. Among a total of 48 osteonecrotic lesions observed, 48 % were detected in the knee; multifocal osteonecrosis were detected in six out of seven patients (86 %).
  
  
  CONCLUSIONS
  The development of osteonecrosis is strictly related to the chemotherapy protocol adopted and the number of cycles received, with a strong correlation between the dose of corticosteroids included in the BEACOPP scheme and this complication. WB-MRI can be considered as a helpful tool that allows detecting earlier osteonecrotic lesions in patients treated with corticosteroids.
  
  
  CONCLUSIONS
  • Osteonecrosis is a possible complication of patients with Lymphoma treated by chemotherapy. • Osteonecrosis is related to the corticosteroids included within the BEACOPP protocol. • WB-MRI allows detecting osteonecrotic lesions in patients treated with corticosteroids.
authors: Department of Radiology, DIBIMED, University of Palermo, Via del Vespro 127, 90127, Palermo, Italy. albanodomenico@me.com.
authors: Domenico
authors: http://orcid.org/0000-0001-7989-9861
authors: D
authors: Albano
authors: Department of Hematology I, Azienda Ospedali Riuniti Villa Sofia-Cervello, Viale Strasburgo 233, 90146, Palermo, Italy.
authors: Caterina
authors: C
authors: Patti
authors: Department of Radiology, DIBIMED, University of Palermo, Via del Vespro 127, 90127, Palermo, Italy.
authors: Ludovico
authors: L
authors: La Grutta
authors: Department of Radiology, DIBIMED, University of Palermo, Via del Vespro 127, 90127, Palermo, Italy.
authors: Emanuele
authors: E
authors: Grassedonio
authors: Department of Hematology I, Azienda Ospedali Riuniti Villa Sofia-Cervello, Viale Strasburgo 233, 90146, Palermo, Italy.
authors: Antonino
authors: A
authors: Mulè
authors: Department of Radiology, DIBIMED, University of Palermo, Via del Vespro 127, 90127, Palermo, Italy.
authors: Giuseppe
authors: G
authors: Brancatelli
authors: Department of Radiology, DIBIMED, University of Palermo, Via del Vespro 127, 90127, Palermo, Italy.
authors: Roberto
authors: R
authors: Lagalla
authors: Department of Radiology, DIBIMED, University of Palermo, Via del Vespro 127, 90127, Palermo, Italy.
authors: Massimo
authors: M
authors: Midiri
authors: Department of Radiology, DIBIMED, University of Palermo, Via del Vespro 127, 90127, Palermo, Italy.
authors: Massimo
authors: M
authors: Galia
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D001761:Bleomycin / Q000008:administration & dosage / Q000009:adverse effects; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D004334:Drug Administration Schedule; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects / Q000627:therapeutic use; D006689:Hodgkin Disease / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D015994:Incidence; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010020:Osteonecrosis / Q000139:chemically induced* / Q000000981:diagnostic imaging; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects; D011344:Procarbazine / Q000008:administration & dosage / Q000009:adverse effects; D012189:Retrospective Studies; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects; D051598:Whole Body Imaging / Q000379:methods; D055815:Young Adult
chemical_list: D005938:Glucocorticoids; D001761:Bleomycin; D011344:Procarbazine; D014750:Vincristine; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone
keywords: BEACOPP; Lymphoma; Magnetic resonance imaging; Osteonecrosis; Whole body imaging