Osteonecrosis detected by whole body magnetic resonance in patients with Hodgkin Lymphoma treated by BEACOPP

Roberto Lagalla, Massimo Midiri, Ludovico La Grutta, Massimo Galia, Giuseppe Brancatelli, Domenico Albano, Caterina Patti, Antonino Mulè, Emanuele Grassedonio

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Objectives: The purpose of our retrospective review of prospectively acquired Whole Body Magnetic Resonance (WB-MRI) scans was to assess the incidence of osteonecrosis in patients who received different chemotherapies. Methods: We evaluated the WB-MRI scans performed on 42 patients with Hodgkin Lymphoma treated by three chemotherapy regimens (6ABVD, 2ABVD + 4BEACOPP, 2ABVD + 8BEACOPP), excluding patients with the main risk factors for osteonecrosis. Results: Six out of seven patients (86 %) who received eight BEACOPP and one out of five patients (20 %) treated by four BEACOPP presented osteonecrosis, with a statistically significant difference of frequency between the two groups of patients (p < 0.05); no injury has been reported in patients treated by only ABVD. Among a total of 48 osteonecrotic lesions observed, 48 % were detected in the knee; multifocal osteonecrosis were detected in six out of seven patients (86 %). Conclusions: The development of osteonecrosis is strictly related to the chemotherapy protocol adopted and the number of cycles received, with a strong correlation between the dose of corticosteroids included in the BEACOPP scheme and this complication. WB-MRI can be considered as a helpful tool that allows detecting earlier osteonecrotic lesions in patients treated with corticosteroids. Key Points: • Osteonecrosis is a possible complication of patients with Lymphoma treated by chemotherapy.• Osteonecrosis is related to the corticosteroids included within the BEACOPP protocol.• WB-MRI allows detecting osteonecrotic lesions in patients treated with corticosteroids.
Original languageEnglish
Pages (from-to)2129-2136
Number of pages8
JournalEuropean Radiology
Publication statusPublished - 2017


All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

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