Tests That Help Evaluate Acute Lymphocytic Leukemia (ALL)
Your doctor may request other tests to learn more about your specific type of leukemia and to see if the leukemia is causing any other problems in your body. This will help your doctor decide on the most effective types of treatment for you. You may need one or more of these tests.
Your doctor may do a chest X-ray to make a picture of the organs and lymph nodes inside your chest. This test cannot show leukemia cells, but it can show if you have an infection in your lungs because of your leukemia. It can also help your doctor see if lymph nodes in this area are swollen. The test only takes a few minutes and it won’t cause any pain.
Doctors use this test to find out if leukemia cells have spread to your brain or spinal cord. This is more likely to be the case with acute types of leukemia, such as ALL. Your doctor first numbs the area around your lower back with a local anesthetic. Then he or she inserts a needle into your spinal cavity near your spinal cord to remove cerebrospinal fluid. Even with the anesthesia, you may feel brief pain while the needle is inserted. The entire procedure takes only about 10 to 20 minutes. Your doctor sends the removed fluid to a lab where a pathologist checks for leukemia cells under a microscope.
Computed Tomography (CT) Scan
Your doctor may use this test to determine if any lymph nodes or organs in your body are enlarged. It isn't often needed to diagnose ALL, but it may be done if your doctor thinks the leukemia may be growing in an organ, like your spleen. CT scans use X-rays directed at the body from several angles to create detailed pictures of the inside of your body. Before the test, you may be asked to drink a contrast solution or get an intravenous (IV) injection of a contrast dye that helps better outline abnormal areas in the body. Some people may have allergic reactions to the contrast. For the test itself, you lie on a table that slides in and out of the scanner while the images are created. This test takes a bit longer than a standard X-ray.
Magnetic Resonance Imaging (MRI)
Your doctor may use this test to determine if leukemia has spread to your chest or brain. MRIs use radio waves and magnetic fields to make a three-dimensional picture of the inside of your body. If the leukemia has spread to lymph nodes or to certain organs, the test can reveal the size and extent of the spread. Your doctor may also use MRIs if the results of an X-ray or CT scan aren’t clear. In some cases, you will be injected with a contrast dye about 30 to 60 minutes before getting the scan. This helps some of your organs show up better. For this test, you lie still on a table as it passes through a tube-like scanner. Then the scanner rotates around you. A computer uses data from radio waves to create pictures of the inside of your body. You may need more than one set of images, and each one may take two to 15 minutes. This test is painless and noninvasive. Ask for earplugs to help block out the loud thumping noise during the scan. If you are claustrophobic, you may receive a sedative before having this test.