• Boaz Karmazyn, Mervyn D Cohen, Samuel Gregory Jennings, and Kent A Robertson.
• Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Riley Hospital for Children, Indiana University Health, 705 Riley Hospital Drive, Rm. 1053, Indianapolis, IN 46260, USA. bkarmazy@iupui.edu
• Pediatr Radiol. 2012 Oct 1;42(10):1218-22.

BackgroundWe observed bone marrow signal changes (BMSC) in patients with plexiform neurofibromas after treatment with imatinib mesylate (Gleevec).ObjectiveTo evaluate the pattern and natural history of BMSC.Materials And MethodsThe data were obtained from a pilot study of imatinib mesylate in patients with plexiform neurofibromas. All patients underwent baseline and sequential whole-body STIR 1.5-T MRI after treatment. The bone marrow signal on MRI was evaluated for abnormalities, location and pattern, and any change on follow-up studies.ResultsThe study group included 16 patients (8 males) with a median age of 14 years (range 4 to 25 years). The mean whole-body MRI follow-up duration was 1.9 years. Of the 16 patients, 14 (88%) developed BMSC. The signal change was asymmetrical in 9 of the 14 patients (64%). The appendicular skeleton was involved in all 14 patients and the axial skeleton in 3 patients (21%). BMSC was followed in 13 patients and decreased signal was seen in 9 patients (69%) after a mean duration of 1.3 years of treatment (range 0.6 to 2.9 years); no complications were observed.ConclusionBMSC appeared in most patients with neurofibromatosis type 1 following treatment with imatinib mesylate. BMSC was unusually asymmetrical and involved the lower extremities. On follow-up, BMSC often showed a decrease without complications.

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