Tests That Help Evaluate Acute Lymphocytic Leukemia

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.

Chest X-ray

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 if you have leukemia, 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, which may also be a sign of leukemia. The test takes only a few minutes and it won’t cause any pain.

Lumbar puncture

This test is also called a "spinal tap." 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 acute lymphocytic leukemia (ALL). Your doctor first numbs the area around your lower back with a local anesthetic. Then he or she inserts a hollow 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.

CT scan

Your doctor may use this test to determine if any lymph nodes or organs in your body are enlarged. The test isn't often needed to diagnose ALL, but your doctor may order it if he or she thinks the leukemia may be growing in one of your organs, 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, your health care provider may ask you to drink a contrast solution, or you may get an IV (intravenous) injection of a contrast dye, that helps to outline abnormal areas in your body. Some people may have allergic reactions to the contrast so tell your doctor if you have any allergies or have ever had a allergic reaction to contrast dye. 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. MRI uses 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, your health care provider will inject you with a contrast dye about 30 to 60 minutes before you get 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 narrow, tube-like scanner. 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 2 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 (anxious in closed spaces), you may receive a sedative before having this test. Getting the test in a newer, more open MRI scanner may be another option.