Blood Res.  2018 Dec;53(4):281-287. 10.5045/br.2018.53.4.281.

Detection of bone marrow involvement with FDG PET/CT in patients with newly diagnosed lymphoma

• Özpolat H
• Yilmaz E
• Goksoy HS
• Özpolat S
• Dogan O
• Unal SN
• Nalcaci M

• KMID: 2429301
• DOI: http://doi.org/10.5045/br.2018.53.4.281

Abstract

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.

Keyword

Lymphoma; Bone marrow biopsy; PET/CT; Bone marrow involvement; Diffuse; Focal involvement

MeSH Terms

Biopsy
Blood Platelets
Bone Marrow*
Electrons
Hodgkin Disease
Humans
Leukocyte Count
Lymphoma*
Positron-Emission Tomography and Computed Tomography*

Figure

• 

  Fig. 1 The study flow chart.Abbreviations: BMB, bone marrow biopsy; BMI, bone marrow involvement; HL, Hodgkin's lymphoma; NHL, non-Hodgkin lymphoma; PET/CT, Positron emission tomography-computed tomography.

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