Bone Marrow Study In Malignant Disorders: Marrow Trephine Biopsy Versus Marrow Magnetic Resonance Imaging.

Bone marrow involvement in malignant disorders is central to both staging and treatment, therefore extremely important. Histopathologic examination for bone marrow involvement is the best diagnostic method, but it can be sometimes misleading in patients with focal involvement while Magnetic Resonance Imaging (MRI) presents more global view of bone marrow and is highly sensitive. The aim of this study was to assess and compare the efficacy of MRI with bone marrow biopsy in evaluation of bone marrow infiltration in various malignant diseases. This study included 100 patients with known malignancies who underwent complete evaluation on both MRI and bilateral bone marrow biopsy. Out of 100 patients, only 45 showed bone marrow involvement. All these 45 cases were positive on MRI but only 39 on bone marrow biopsy. Six cases showed marrow involvement on MRI but their bone marrow biopsy did not show any marrow infiltration but certain secondary changes were present in the form of increase in eosinophils, prominance of lymphocytes, mild fibrosis, or reactive plasmacytosis in various malignant disorders respectively. Thus we conclude that both bilateral iliac crest bone marrow biopsies and marrow MRI are important in establishing bone marrow involvement in cancer patients. This study also indicates that sensitivity of marrow MRI in detecting marrow infiltration is higher as compared to bone marrow biopsy especially when marrow is involved focally which may show secondary changes only on marrow biopsy.