Imaging of Skeletal Involvement in Hemolymphatic Disorders
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GERIATRICS (G GUGLIELMI, SECTION EDITOR)
Imaging of Skeletal Involvement in Hemolymphatic Disorders Paola Crivelli1 • Elisa Baratella2 • Stefano Zedda3 • Cristina Marrocchio4 Maria Assunta Cova5 • Maurizio Conti3
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Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review This paper is aimed at describing the main malignant hematolymphoid disorders and their most frequent imaging appearance. Recent Findings Hematological malignancies are a heterogeneous group of neoplasms, including leukemia, lymphoma, and multiple myeloma that may involve the bone marrow as a primary or metastatic disease. Imaging has a pivotal role in the assessment of bone involvement, staging, and evaluation of treatment response and detection of complications. Summary Radiologist should be aware of most frequent findings of hematological malignant diseases, in order to perform an earlier diagnosis as well as assess an adequate clinical-therapeutic pathway. Keywords Hematological malignancies Leukemia Lymphoma Multiple myeloma Systemic mastocytosis Imaging
This article is part of the Topical Collection on Geriatrics. & Paola Crivelli [email protected] 1
Institute of Diagnostic Imaging 2, AOU Sassari, Sassari, Italy
2
Department of Radiology, University of Trieste, Trieste, Italy
3
Department of Clinical and Experimental Medicine, Institute of Diagnostic Imaging 2, University of Sassari, Sassari, Italy
4
Department of Medicine, Surgery and Health Science, University of Trieste, Trieste, Italy
5
Department of Radiology, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), Strada di Fiume 447, Trieste, Italy
Introduction Hematological malignancies are a heterogeneous group of neoplasms, including leukemia, lymphoma, and multiple myeloma that may involve the bone marrow as a primary or metastatic disease. Imaging has an important role in the assessment of bone involvement, staging, and evaluation of treatment response and detection of complications. Musculoskeletal involvement can be assessed with numerous imaging modalities including radiography, which is usually the first exam performed, computed tomography (CT), fluorine 18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT), and fluorodeoxyglucose positron emission tomography/magnetic resonance imaging (FDG PET/ MRI), which is a more recent and emerging imaging tool for the evaluation of hematological malignancies, since MRI is considered a fundamental exam to evaluate bone marrow alterations. The normal yellow bone marrow has a signal intensity higher than muscles on T1-weighted sequences and an intermediate to low signal intensity on T2-weighted and short tau inversion recovery (STIR) sequences. The red bone marrow has an intermediate signal intensity, lower than subcutaneous fat but higher than muscles, on T1-weighted sequences, a signal intensity slightly lower than yellow marrow on T2-weighted sequences, and an intermediate signal intensity,
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