Utility of F-fluorodeoxyglucose PET-CT Scan in Detecting Bone Marrow Involvement in Lymphoma

Overview

Journal Indian J Med Res

Specialty General Medicine

Date 2022 May 9

PMID 35532587

Authors

Ankit Kumar Jitani

Shyamali Dutta

Prakas Kumar Mandal

Rajib De

Ekta Jajodia

Shuvraneel Baul

Prantar Chakrabarti

Tuphan Kanti Dolai

Affiliations

Soon will be listed here.

Abstract

Background & Objectives: Evaluation of bone marrow infiltration in lymphoma is usually done by bone marrow biopsy (BMB). This study analyzed the utility of F-fluorodeoxyglucose positron emission tomography/computerized tomography (F-FDG PET/CT) to detect bone marrow involvement (BMI) compared to BMB.

Methods: Treatment-naïve lymphoma patients underwent both F-FDG PET/CT scan and BMB before treatment initiation. BMI detected on PET/CT was compared with BMB.

Results: The study population consisted of 80 patients and comprised 37 Hodgkin's lymphoma (HL) patients, 30 aggressive non-HL (NHL) and 13 indolent NHL patients. The majority of the aggressive NHLs were diffuse large B-cell lymphoma (20/30) and major indolent lymphoma was follicular lymphoma (5/13). When compared to BMB, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of focal (±diffuse) marrow FDG uptake on F-FDG PET/CT were 100, 61.3, 33.3 and 100 per cent, respectively, for HL; 100, 65.4, 30.8 and 100 per cent, respectively, for aggressive NHL and 75, 80, 85.7 and 66.7 per cent, respectively, for indolent NHL. When comparing marrow involvement on F-FDG PET/CT to baseline BMB and/or resolution of bone marrow FDG uptake at interim/end-of-treatment F-FDG PET/CT, the sensitivity, specificity, PPV and NPV were 100 per cent each for HL and aggressive NHL and 77.3, 100, 100 and 66.7 per cent, respectively, for indolent NHL.

Interpretation & Conclusions: F-FDG PET/CT has a good sensitivity and NPV for detecting BMI in HL and aggressive lymphoma. The low specificity and PPV improved if marrow uptake pattern on interim or end-of-treatment F-FDG PET/CT scan was analyzed. In patients with HL who are staged withF-FDG PET/CT at baseline and followed up with an interim/end-of-treatment PET/CT, baseline BMB may be avoided. For all other lymphoma subtypes, BMB may be essential if there is no marrow FDG uptake on PET/CT scan performed at baseline.

Citing Articles

PET-CT in Clinical Adult Oncology: I. Hematologic Malignancies.

Salem A, Shah H, Covington M, Koppula B, Fine G, Wiggins R Cancers (Basel). 2022; 14(23).

PMID: 36497423 PMC: 9738711. DOI: 10.3390/cancers14235941.

Detecting marrow involvement in lymphoma: Can-F fluorodeoxyglucose positron emission tomography elude the need for biopsy?.

Kaushik P, Tripathi M Indian J Med Res. 2022; 154(5):658-660.

PMID: 35532582 PMC: 9210534. DOI: 10.4103/ijmr.ijmr_1571_21.

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