Imaging of bone marrow involvement in lymphoma: state of the art and future directions

Accurate detection of bone marrow involvement in patients with lymphoma is of crucial importance because of the prognostic and therapeutic consequences. Bone marrow trephine biopsy (BMB) is currently regarded as the method of choice for the evaluation of the bone marrow in lymphoma, but it is invasive, has a risk of complications, and lacks sufficient sensitivity due to the possibility of sampling errors. Bone marrow imaging, if accurate, may (partially) replace BMBand/or may improve the sensitivity of BMB by guiding the biopsy to the location that appears to be involved by lymphoma at imaging. In this scientific communication, general concepts of bone marrow imaging, state-of-the-art imaging modalities, and future imaging strategies for the assessment of the bone marrow in lymphoma will be reviewed and discussed.