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Radiation-induced Changes in MR Signal Intensity and Contrast Enhancement of Lumbosacral Vertebrae: Do Changes Occur Only Inside the Radiation Therapy Field?¹

¹ From the Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City. Received November 15, 2000; revision requested January 10, 2001; final revision received June 4; accepted August 1. Supported in part by National Institutes of Health grant 1 RO1 CA71906-01A2. Address correspondence to S.O., Department of Radiology, Toki Municipal General Hospital, 703-24 Tokitsuguchi, Tokitsu-cho, Toki, Gifu 509-5193 Japan.

PURPOSE: To evaluate temporal changes in signal intensity (SI) and degree of contrast enhancement (CE) of bone marrow in lumbosacral vertebrae inside and outside the radiation therapy (RT) field.

MATERIALS AND METHODS: Twenty-three patients with advanced uterine cervical cancer who were treated with RT were prospectively evaluated. Each patient underwent four dynamic magnetic resonance (MR) studies: before RT, 2 and 4 weeks after initiation of RT, and 4 weeks after completion of RT. SI and CE were calculated in all four studies of each patient.

RESULTS: Bone marrow inside the RT field showed steady and marked increase in precontrast SI and early and transient increase in CE at 2 weeks after initiation of RT followed by progressive and marked decrease in CE at 4 weeks after initiation of RT and 4 weeks after completion of RT. Bone marrow outside the RT field showed slight increase in precontrast SI and steady and moderate decrease in CE to a lesser degree without early increase as seen in bone marrow inside the RT field.

CONCLUSION: RT causes an increase in precontrast SI predominantly in bone marrow inside the RT field. However, a decrease in CE is seen in bone marrow not only inside but also outside the RT field.

Index terms: Bone marrow, effects of irradiation on, 331.47 • Magnetic resonance (MR), contrast enhancement, 331.121411, 331.12143 • Radiation, injurious effects, 331.47 • Spine, MR, 331.121411, 331.12143

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