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Off-midline non-contrast-enhanced sagittal T1-weighted MR image (600/12/1) in a 48-year-old woman with breast cancer who presented with headache and fatigue. Overall, heterogeneous marrow is hypointense relative to WM. A subsequent bone scan was diffusely abnormal. Pelvic marrow biopsy revealed metastatic adenocarcinoma. In this patient, alteration of the marrow signal intensity on T1-weighted images was the first indication of metastatic disease.
