Estimation of bone marrow cellularity by means of vertebral magnetic resonance

Postgraduate School of Hematology Farreras Valenti, Barcelona, Spain.

BACKGROUND AND OBJECTIVE: A magnetic resonance (MR) signal shows an inverse correlation with bone marrow cellularity. In this study, we investigated the possibility of estimating the degree of bone marrow cellularity by means of this non-invasive technique. METHODS: In 25 patients with different hematological disorders and homogeneous bone marrow distribution, the percentage of bone marrow cellularity was compared to the MR signal of four middorsal vertebrae in T1 sequence. As internal control, the MR signal of the mid-dorsal spinal cord region was used. The results were expressed as the MR signal ratio (great mean MR signal of four vertebrae/MR signal of the spinal cord). RESULTS: The correlation coefficient (r) between both parameters was -0.93 (p < 0.0001). All observed values fell within the 90% limits of predicted values. The mean difference between observed and predicted bone marrow cellularity was 5.6 (SD 4.0)%. INTERPRETATION AND CONCLUSIONS: The measurement of the MR signal is not easy to standardize since it depends to a large degree on the control employed. The spinal cord proved to be a satisfactory internal control of the MR signal. Within defined conditions, MR can be useful for a rough estimate of bone marrow cellularity in several clinical situations, such as analysis of tumor burden for prognosis of some leukemias and the evaluation of response to therapy in both proliferative and hypoplastic disorders.