European Radiology

, Volume 27, Issue 5, pp 2129–2136 | Cite as

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

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



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.


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.


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 %).


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.


Magnetic resonance imaging Whole body imaging Lymphoma Osteonecrosis BEACOPP 



Hodgkin Lymphoma


Doxorubicin, Bleomycin, Vinblastine and Dacarbazine


Bleomycin, Etoposide, Doxorubicin, Cyclophosphamide, Vincristine, Procarbazine, Prednisone


Whole Body Magnetic Resonance


Fluorodeoxyglucose-Positron Emission Tomography/Computed tomography





The scientific guarantor of this publication is Prof. Massimo Galia. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. The Ethics Board granted exempt status for this retrospective study with a waiver of the requirement for informed consent. Methodology: retrospective, diagnostic study, performed at one institution.


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Copyright information

© European Society of Radiology 2016

Authors and Affiliations

  • Domenico Albano
    • 1
  • Caterina Patti
    • 2
  • Ludovico La Grutta
    • 1
  • Emanuele Grassedonio
    • 1
  • Antonino Mulè
    • 2
  • Giuseppe Brancatelli
    • 1
  • Roberto Lagalla
    • 1
  • Massimo Midiri
    • 1
  • Massimo Galia
    • 1
  1. 1.Department of Radiology, DIBIMEDUniversity of PalermoPalermoItaly
  2. 2.Department of Hematology IAzienda Ospedali Riuniti Villa Sofia-CervelloPalermoItaly

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