The use of whole body magnetic resonance imaging in detecting bone marrow disorders - a valid alternative to imaging modalities that utilise ionising radiation

Imaging modalities for investigation of bone marrow abnormalities have traditionally involved the use of ionising radiation. Now magnetic resonance imaging (MRI) offers an alternative to x-rays, computer tomography (CT), nuclear medicine bone scans and bone mineral densitometry. This study attempts to evaluate the sensitivity and specificity of whole body MRI in detecting bone marrow abnormalities, using Tl and short tau inversion recovery (STIR) weighted sequences. This was achieved by reviewing already acquired scan data to discover whether this method is more sensitive to marrow changes than conventional radiographic skeletal surveys and other imaging tests, involving ionising radiation. The study involved 10 adult participants all of whom suffered from heamatological malignancies, including multiple myeloma, plasma cell dyscrasia, non-Hodgkin's lymphoma and acute lymphocytic leukaemia. Most of the study group presented with multiple myeloma. Abnormal skeletal MRI findings were reported in nine out of the 10 participants, i.e., a positive detection rate of 90%, using whole body MRI. All participants in the study who suffered from multiple myeloma or plasma cell dyscrasia showed positive MRI findings regardless of the stage of their disease. Four already had a confirmed diagnosis prior to the MRI scan, which was either visible on x-ray or bone scintigraphy. Three participants had positive serum/urine tests, but negative radiographic findings. The study therefore established that, when investigating possible marrow disorders, MRI was more sensitive to changes in the bone-marrow producing part of the skeleton and that MRI therefore must be considered a more suitable imaging tool. Copyright (2005) Australian Institute of Radiography