Advances in Bone Marrow Imaging: Strengths and Limitations from a Clinical Perspective

Conventional magnetic resonance imaging (MRI) remains the modality of choice to image bone marrow. However, the last few decades have witnessed the emergence and development of novel MRI techniques, such as chemical shift imaging, diffusion-weighted imaging, dynamic contrast-enhanced MRI, and whole-body MRI, as well as spectral computed tomography and nuclear medicine techniques. We summarize the technical bases behind these methods, in relation to the common physiologic and pathologic processes involving the bone marrow. We present the strengths and limitations of these imaging methods and consider their added value compared with conventional imaging in assessing non-neoplastic disorders like septic, rheumatologic, traumatic, and metabolic conditions. The potential usefulness of these methods to differentiate between benign and malignant bone marrow lesions is discussed. Finally, we consider the limitations hampering a more widespread use of these techniques in clinical practice.

Automated summary

This article summarizes that conventional magnetic resonance imaging (MRI) is the preferred technique for imaging bone marrow, but new MRI techniques and nuclear medicine techniques have emerged in recent decades. The technical bases of these methods are presented in relation to common physiological and pathological processes involving the bone marrow. The strengths and limitations of these imaging methods are discussed, as well as their added value compared to conventional imaging in assessing non-neoplastic disorders. The potential usefulness of these methods in differentiating between benign and malignant bone marrow lesions is also discussed, along with the limitations hindering their widespread use in clinical practice.