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KMID : 1142020180530040281
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Blood Research
2018 Volume.53 No. 4 p.281 ~ p.287
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Detection of bone marrow involvement with FDG PET/CT in patients with newly diagnosed lymphoma
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Ozpolat H. Tahsin
Yilmaz Ebru
Goksoy Hasan Sami
Ozpolat Sahre
Dogan Oner
Unal Seher Nilgun
Nalcaci Meliha
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Abstract
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Background: Bone marrow involvement (BMI) affects the lymphoma stage, survival, and treatment. Bone marrow biopsy (BMB) and fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET/CT) are useful techniques to detect BMI. Both have advantages and disadvantages. We aimed to identify factors that could be used to predict BMI with positive and negative results on PET/CT compare them with BMB in newly diagnosed patients with lymphoma.
Methods: We included 22 non-Hodgkin and 16 Hodgkin lymphoma patients in this single center study. All patients had PET/CT examination and BMB before treatment. BMI in BMB was reported as negative or positive. Bone marrow was classified into 3 types by FDG uptake on PT/CT; diffuse involvement, focal involvement, and normal bone marrow.
Results: PET/CT and BMB results were concordant (7 positive, 15 negative) in 22 patients (57%). We evaluated concordant and discordant patient characteristics and risk-stratified patients for BMI. Our findings suggest that patients with diffuse FDG uptake on PET/CT, especially patients with advanced age and low platelet and white blood cell counts, are likely to have BMI and could potentially forego BMB. Patients with negative PET/CT findings and no significant laboratory abnormalities are very unlikely to have BMI.
Conclusion: Our results suggest that BMI should not be decided solely based PET/CT or BMB findings. It is reasonable to use both diagnostic assays along with clinical and laboratory findings. PET/CT result, clinical and laboratory findings could be useful for predicting BMI in patient for whom BMB is contraindicated.
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KEYWORD
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Lymphoma, Bone marrow biopsy, PET/CT, Bone marrow involvement, Diffuse, Focal involvement
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