Water-fat MRI for assessing changes in bone marrow composition due to radiation and chemotherapy in gynecologic cancer patients

J Magn Reson Imaging. 2013 Dec;38(6):1578-84. doi: 10.1002/jmri.24071. Epub 2013 Feb 28.

Abstract

Purpose: To assess the feasibility of using fat-fraction imaging for measuring marrow composition changes over large regions in patients undergoing cancer therapy.

Materials and methods: Thirteen women with gynecologic malignancies who were to receive radiation and/or chemotherapy were recruited for this study. Subjects were imaged on a 3T magnetic resonance (MR) scanner at baseline (after surgery but before radiation or chemotherapy), 6 months, and 12 months after treatment. Water-fat imaging was used to generate high-resolution, 3D signal fat fraction (sFF) maps extending from mid-femur to L3. Treatment changes were assessed by measuring marrow sFF in the L4 vertebra, femoral necks, and control tissues.

Results: Pretreatment and 6-month scans were compared in nine women. sFF increased significantly in both the L4 vertebral marrow (P = 0.04) and the femoral necks (P = 0.03), while no significant change was observed in control regions. Qualitatively, chemotherapy changes were more uniform in space, whereas the radiation-induced changes were largest in marrow regions inside and close to the target radiation field.

Conclusion: Water-fat MRI is sensitive to changes in red/yellow marrow composition, and can be used for quantitative and qualitative assessment of treatment-induced marrow damage.

Keywords: Dixon MRI; bone marrow; water-fat imaging.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adipose Tissue / pathology*
  • Adult
  • Body Water / cytology
  • Bone Marrow / drug effects
  • Bone Marrow / pathology
  • Bone Marrow / radiation effects
  • Bone Marrow Diseases / etiology*
  • Bone Marrow Diseases / pathology*
  • Chemoradiotherapy / adverse effects*
  • Female
  • Genital Neoplasms, Female / complications
  • Genital Neoplasms, Female / pathology*
  • Genital Neoplasms, Female / therapy*
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Middle Aged
  • Treatment Outcome