Signal Intensity (SI) of Bone Marrow (BM) on MRI in Women with Breast Cancer

Inna Bokov 1,2 Meirav Ben-David 3 Ori Haisraely 3 Miri Sklair-Levy 1
1Department of Radiology, Sheba Medical Center, Israel
2Department of Radiology, Kaplan Medical Center, Israel
3Radiation Oncology, Sheba Medical Center, Israel

PURPOSE: To evaluate the change of MRI signal intensity (SI) of bone marrow before, at the end and 1 year after chemotherapy (NAT neoadjuvant treatment) in women with breast cancer.

METHODS: This retrospective study between the years 2012-20174 included 92 women diagnosed with breast cancer and treated with neoadjuvantchemotherapy (NAT). SI of bone marrow was measured in sternum (ROI – region of interest) on the first subtraction sequence (T1-weighted after gadolinium injection). In addition as a reference , signal intensity of chest wall muscle was measured on the same sequence where it was best seen.

MRI signal intensity of bone marrow (SI BM index) to muscle index was calculated by division of SI of bone marrow to SI of muscle.

The index was measured prior to, at the completion of and after one year of treatment.

Breast MRI was performed 1.5 T (GE) with a dedicated breast coil (7chanels).

For statistical analysis correlation between the bone marrow index and age, stage , time fromtreatment was evaluated using ANOVA test

RESULTS: Mean patient age was 49.93 ±10.2

In 98% of the women the diagnosis was IDC. NAC included , AC-T – 45/5 % , AC – TH 21%, AC – THP – 23% , in addition novolastinand steroids were added .

Sternum / Muscle index before treatment was 1.6(1.92± 1.1), after treatment 3(3.49±2.15) and at 1 year follow up 1.3.

The pretreatment index was higher in women younger than 48y.

CONCLUSION: The MRI signal intensity of bone marrow may be high in women with breast cancer receiving NAT. This should not be confused with pathological enhancement suspicious of metastatic disease.

Inna Bokov
Inna Bokov