Assessment of bone marrow inflammation in patients with myelofibrosis: an 18F-fluorodeoxyglucose PET/CT study

Derlin, Thorsten; Alchalby, Haefaa; Bannas, Peter; Veldhoen, Simon; Apostolova, Ivayla; Triviai, Ioanna; Bengel, Frank M.

doi:10.1007/s00259-014-2983-4

Cited by 16 publications

(26 citation statements)

References 36 publications

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“…However, the imaging patterns in PMF of the respective radiopharmaceutical distribution are not similar. In a recent study, 18 F‐FDG PET/CT uptake was increased in the axial and distal skeleton when the degree of marrow fibrosis was low (grade I) and was rather mild when the degree of marrow fibrosis was high (grade III) . The authors concluded a significant inverse correlation between the extent of the metabolically active disease (axial skeleton and distal skeleton plus spleen) and time since the diagnosis of myelofibrosis .…”

Section: Discussionmentioning

confidence: 97%

“…In a recent study, 18 F-FDG PET/CT uptake was increased in the axial and distal skeleton when the degree of marrow fibrosis was low (grade I) and was rather mild when the degree of marrow fibrosis was high (grade III) [13]. The authors concluded a significant inverse correlation between the extent of the metabolically active disease (axial skeleton and distal skeleton plus spleen) and time since the diagnosis of myelofibrosis [13]. This reported inverse correlation pattern with 18 F-FDG PET/CT assessment contrasts with the 111 In-Cl 3 /SPECT/CT imaging we observed in the sMF patient (P5) of our series who was at an early phase of the disease and showing a lower fixation to 99m Tc nanocolloids and 111 In-Cl 3 at the distal skeleton.…”

Section: Inflammatory Versus Myelofibrotic Component Of Pmfmentioning

confidence: 92%

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Assessment of sites of marrow and extramedullary hematopoiesis by hybrid imaging in primary myelofibrosis patients

Ojeda‐Uribe

Morel²,

Ungureanu³

et al. 2016

Cancer Medicine

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We investigated noninvasive procedures by hybrid imaging to assess the sites of active or inactive hematopoiesis in patients with primary myelofibrosis (PMF). To this end, we used two radionuclides, technetium 99m (99mTc) and indium 111‐chloride (111In‐Cl3), coupled with single‐photon emission tomography/computed tomography (SPECT/CT). We studied five patients with PMF and one with secondary myelofibrosis (MF). The classical pattern of lower fixation of both tracers at the axial skeleton where the myelofibrotic process occurs and the reactivation of sites of active hematopoiesis at the distal skeleton were confirmed. Coupling both radionuclides to SPECT/CT imaging allowed for more precise visualization of the sites of extramedullary hematopoiesis as those observed in the spleen and liver. Splenic high uptake of 111In‐Cl3 coupled with SPECT/CT represents a pathognomonic feature of PMF. We conclude that, the hybrid imaging procedures that we studied might constitute an alternative noninvasive method for the screening of the whole‐body marrow and, by this way, to assess the impact of targeted therapies in PMF patients in whom it is well known that the distribution of the hematopoietic active areas is disturbed. Hybrid imaging could also be useful for diagnostic purposes in cases of early PMF or in suspected cases of myelofibrosis secondary to polycythemia vera or essential thrombocythemia.

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Section: Discussionmentioning

confidence: 97%

Section: Inflammatory Versus Myelofibrotic Component Of Pmfmentioning

confidence: 92%

Assessment of sites of marrow and extramedullary hematopoiesis by hybrid imaging in primary myelofibrosis patients

Ojeda‐Uribe

Morel²,

Ungureanu³

et al. 2016

Cancer Medicine

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“…A recent study has demonstrated the feasibility of 18 F-FDG PET/CT for noninvasive visualization and quantitation of the extent and activity of bone marrow involvement in a cohort of patients before SCT (4). In that study, the metabolic activity of the bone marrow as determined by 18 F-FDG PET was significantly associated with the histopathologic grade of fibrosis, and the extent of disease on PET decreased with time after diagnosis.…”

mentioning

confidence: 79%

“…The final bone marrow SUV max results were produced by averaging the measurements for all 4 vertebrae. Lumbar bone marrow SUV max has previously been shown to be inversely correlated with the histopathologic grade of bone marrow fibrosis (4).…”

Section: Reference Standardmentioning

confidence: 99%

Serial ¹⁸F-FDG PET for Monitoring Treatment Response After Allogeneic Stem Cell Transplantation for Myelofibrosis

et al. 2016

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Our objective was to assess the feasibility of 18 F-FDG PET/CT for noninvasive monitoring of treatment response after allogeneic stem cell transplantation (SCT) for myelofibrosis. Methods: Twelve patients with myelofibrosis underwent 18 F-FDG PET/CT before and after SCT. Bone marrow uptake, spleen uptake, and spleen size were assessed before and after SCT and compared with hematologic response criteria and bone marrow biopsies. Results: All patients who did not achieve complete remission remained PET-positive (P 5 0.02). Extent of disease, bone marrow metabolism, spleen metabolism, and spleen volume decreased significantly in patients with complete remission (P 5 0.03). PET/CT after SCT had a sensitivity of 1.0 (95% confidence interval [CI], 0.54-1.0), a specificity of 0.83 (95% CI, 0.36-1.0), a negative predictive value of 1.0 (95% CI, 0.48-1.0), and a positive predictive value of 0.86 (95% CI, 0.42-1.0) for diagnosis of residual disease. Conclusion: 18 F-FDG PET/CT is feasible for noninvasive monitoring of treatment response after allogeneic SCT for myelofibrosis.

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“…In a larger cohort including 57 patients, a complete or near complete resolution of bone marrow fibrosis at day +100 after reduced intensity allogeneic stem cell transplantation resulted in a favorable survival independently of IPSS risk score at transplantation and correlated with improved graft function and significantly less red blood cell and platelet transfusions [43]. Regression of bone marrow fibrosis is determined by bone marrow histology but can be monitored also by magnetic resonance imaging (MRI) [44] or more recently by positron emission tomography/computed tomography (PET/CT) [45] which is a promising technique for quantitation of bone marrow inflammation in myelofibrosis [46].…”

Section: Kinetics Of Bone Marrow Fibrosis Regressionmentioning

confidence: 99%

Current Challenges in Stem Cell Transplantation in Myelofibrosis

Kröger

2015

Curr Hematol Malig Rep

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Primary or post-ET/PV myelofibrosis is one of the Philadelphia-negative myeloproliferative neoplasms with worst survival. Allogeneic stem cell transplantation (ASCT) can cure a substantial number of patients but is still not universally applicable due to toxicity which leads to therapy-related morbidity and mortality. In the more recent years, outcome of ASCT has improved by less toxic conditioning regimens and optimization of relapse prevention strategies. The introduction of novel therapies such as JAK2 inhibitors may also be helpful in preparation of the transplant by reducing spleen size and constitutional symptoms. To reduce the risk of relapse, molecular monitoring and adoptive immunotherapy with donor lymphocytes have been introduced. Despite lacking prospective randomized trials, it is justified to offer ASCT to eligible patients with PMF whose median survival is expected to be less than 5 years. This includes patients with intermediate-2 and high risk according to IPSS or DIPSS, respectively. The benefit/risk ratio should be considered in each patient taking also transplant- and patient-specific factors into account.

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Assessment of bone marrow inflammation in patients with myelofibrosis: an 18F-fluorodeoxyglucose PET/CT study

Cited by 16 publications

References 36 publications

Assessment of sites of marrow and extramedullary hematopoiesis by hybrid imaging in primary myelofibrosis patients

Assessment of sites of marrow and extramedullary hematopoiesis by hybrid imaging in primary myelofibrosis patients

Serial ¹⁸F-FDG PET for Monitoring Treatment Response After Allogeneic Stem Cell Transplantation for Myelofibrosis

Current Challenges in Stem Cell Transplantation in Myelofibrosis

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Assessment of bone marrow inflammation in patients with myelofibrosis: an 18F-fluorodeoxyglucose PET/CT study

Cited by 16 publications

References 36 publications

Assessment of sites of marrow and extramedullary hematopoiesis by hybrid imaging in primary myelofibrosis patients

Assessment of sites of marrow and extramedullary hematopoiesis by hybrid imaging in primary myelofibrosis patients

Serial 18F-FDG PET for Monitoring Treatment Response After Allogeneic Stem Cell Transplantation for Myelofibrosis

Current Challenges in Stem Cell Transplantation in Myelofibrosis

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Serial ¹⁸F-FDG PET for Monitoring Treatment Response After Allogeneic Stem Cell Transplantation for Myelofibrosis