Type:
Educational Exhibit
Keywords:
Neoplasia, Multidisciplinary cancer care, Observer performance, MR, Oncology, Musculoskeletal bone, MR physics
Authors:
B. Alvarez de Sierra Garcia, A. Alonso Burgos, F. M. Caballeros, G. Gallardo Madueño, C. Sobrido, V. M. Suárez Vega; MADRID/ES
DOI:
10.26044/ecr2019/C-2226
Background
INTRODUCTION Fig. 1
Bone marrow edema is a pattern of marrow alteration frequently observed at MRI in cancer patients.
Distinguishing metastatic disease from non-oncological bone marrow edema can sometimes be challenging; however,
there are several clues that can be used in the differentiation.
The main task of the radiologist is to asses the bone marrow edema and to form an appropriate differential diagnosis by identify specific patterns and/or locations of bone marrow edema.
Recognizing these patterns of bone marrow edema on MRI is essential in daily clinical practice to tailor the most appropiate treatment (resolutive versus non-resolutive process).
BONE MARROW EDEMA: HISTOLOGICAL FINDINGS AND AETIOLOGY
Bone marrow edema (BME) represents an increase of interstitial water content
The aetiology of bone marrow edema is still unclear with a number of theories having been proposed including reactive inflammatory change in adjacent normal tissue and transudate of fluid through hypervascular tumour capillaries.
MR technique for evaluation of BME in cancer patients
Magnetic resonance imaging (MRI) is a very sensitive modality to detect marrow abnormalities.
It is considered a technique of reference for the evaluation of bone marrow involvement for a large variety of solid tumors
MRI protocol Fig. 2
MR imaging was performed with a 3-T MR imaging system (Magnetom Vida; Siemens Medical Solutions,
Erlangen,
Germany). The standard protocol for the detection and characterization of BME should include the next combination. Fig. 3