Radiation induced fatty marrow replacement

Case contributed by Dr Ian Bickle


Back pain. Previous history of gynaecological cancer, which including radiotherapy treatment.

Patient Data

Age: 58

High signal on both T1 and T2 in a very demarcated fashion involving L2 to the sacrum.

No focal bone lesion.

Conus and cauda equina normal. 

Case Discussion

This example shows fatty replacement of the bone marrow due to radiation therapy. After 3-6 weeks marrow cellularity is replaced by central fat predominantly surrounding the basivertebral veins.  Hence on all MRI sequences in the zone of radiation therapy the bones return signal consistently with fat.

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Case information

rID: 46640
Published: 5th Aug 2016
Last edited: 14th Aug 2019
System: Spine, Oncology
Inclusion in quiz mode: Included

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