Can FDG-PET/CT replace blind bone marrow biopsy of the posterior iliac crest in Ewing sarcoma?

Kasalak, Ömer; Glaudemans, Andor W J M; Overbosch, Jelle; Jutte, Paul C.; Kwee, Thomas C.

doi:10.1007/s00256-017-2807-2

Cited by 29 publications

(20 citation statements)

References 11 publications

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“…New imaging techniques such as PET and PET/CT have been demonstrated to have high sensitivity, specificity, and accuracy in detecting bone metastases in some pediatric and young adult tumors and proved to be as effective as BMB in identifying bone marrow metastases in lymphoma patients . Recently, some authors have studied this aspect of PET in ES, suggesting its potential use in the detection of bone marrow involvement . The purpose of the present study was not to evaluate the role of PET in the diagnosis of bone marrow metastases in ES; therefore, no conclusions can be drawn based on our data.…”

Section: Discussionmentioning

confidence: 86%

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Bone marrow biopsy in the initial staging of Ewing sarcoma: Experience from a single institution

Cesari

Righi

Colangeli

et al. 2019

Pediatric Blood & Cancer

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Background Ewing sarcoma (ES) is the second most common bone tumor in adolescents and children. Staging workup for ES includes imaging and bone marrow biopsy (BMB). The effective role of BMB is now under discussion. Procedure A monoinstitutional retrospective analysis reviewed clinical charts, imaging, and histology of patients with diagnosis of ES treated at the Rizzoli Institute between 1998 and 2017. Results The cohort included 504 cases of ES of bone; 137 (27%) had metastases at diagnosis, while the remaining 367 had localized disease. Twelve patients had a positive BMB (2.4%). Eleven had distant metastases detected at initial workup staging with imaging assessment: six patients presented with bone metastases, five with both bone and lung metastases. Only one patient with ES of the foot (second metatarsus) was found to have bone marrow involvement with negative imaging evaluation (0.3%). Conclusions On the basis of our data, we suggest reconsidering the effective role of BMB in initial staging workup for patients with ES with no signs of metastases by modern imaging techniques. In metastatic disease, the assessment of the bone marrow status may remain useful to identify a group of patients at very high risk who could benefit from different treatment strategies.

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Section: Discussionmentioning

confidence: 86%

“…18 Recently, some authors have studied this aspect of PET in ES, suggesting its potential use in the detection of bone marrow involvement. 19 The purpose of the present study was not to evaluate the role of PET in the diagnosis of bone marrow metastases in ES; therefore, no conclusions can be drawn based on our data.…”

Section: Discussionmentioning

confidence: 88%

Bone marrow biopsy in the initial staging of Ewing sarcoma: Experience from a single institution

Cesari

Righi

Colangeli

et al. 2019

Pediatric Blood & Cancer

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“…Furthermore, the presence of bone marrow involvement does not affect the treatment strategy of patients with known distant metastases. Recent reports emphasized the finding suggesting that bone marrow involvements are unlikely to be observed if no metastases are detected on the imaging modalities [13,17]. Newman et al retrospectively evaluated patients with ES/PNET who underwent both 18 F-FDG PET and BMAB of the iliac crest [13].…”

Section: Discussionmentioning

confidence: 99%

Bone marrow examination in patients with Ewing sarcoma/peripheral primitive neuroectodermal tumor without metastasis based on 18F-fluorodeoxyglucose positron emission tomography/computed tomography

Inagaki

Shimoi²,

Okuma³

et al. 2019

Med Oncol

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Ewing sarcoma/peripheral primitive neuroectodermal tumor (ES/PNET) is an aggressive bone tumor. Bone marrow aspiration and biopsy (BMAB) has been recognized as the gold standard for assessing bone marrow status. While the latest guideline suggests the need to omit bone marrow aspiration in patients with no findings on 18 F-fluorodeoxyglucose positron emission tomography ( 18 F-FDG PET) based on one retrospective report, there is no study using 18 F-FDG PET/computed tomography (CT). We retrospectively reviewed 26 consecutive, previously untreated, ES/PNET patients. We compare the results of bone marrow aspiration and biopsy (BMAB) and those of 18 F-FDG PET/CT in ES/PNET patients. All of the 21 patients without metastases on 18 F-FDG PET/CT had negative BMAB. The sensitivity of bone marrow involvement in bone metastases positive patients on 18 F-FDG PET/CT was 75% (3/4), and the specificity was 100% (22/22). In addition to the metastatic findings on 18 F-FDG PET/CT, tumor diameter, lactate dehydrogenase level at diagnosis, and the presence or absence of bone metastasis were factors related to bone marrow involvement. It may be a reasonable option to omit BMAB in ES/PNET patients with no distant metastasis based on 18 F-FDG PET/CT findings.

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“…After careful selection, 23 articles published in English were included in the meta-analysis. [15–36] The detailed article search and study selection process were listed in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

“…A total of 13 trials, [16,18–20,22,25–27,29–31,34,36] involving 689 lesions, were available to investigate the diagnostic performance of 18 F-FDG PET and PET/CT in ESFT. The pooled results were as follows: sensitivity of 86% (95% CI of 82%–89%), specificity of 80% (95% CI of 75%–85%), PLR of 3.92 (95% CI of 3.08–4.98), NLR of 0.19 (95% CI of 0.12–0.30) and DOR of 29.22 (95% CI of 16.49–51.78).…”

Section: Resultsmentioning

confidence: 99%

Effectiveness of 18F-FDG PET/CT in the diagnosis, staging and recurrence monitoring of Ewing sarcoma family of tumors

Huang

Zhi-yong

et al. 2018

Medicine

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Background:To investigate the value of positron emission tomography (PET) and PET/computed tomography (CT) using fluorine-18-fluorodeoxyglucose (18F-FDG) in the diagnosis, staging, restaging and recurrence monitoring of Ewing sarcoma family of tumors (ESFTs), a meta-analysis was performed through systematically searching PubMed, Embase, and Cochrane Central library to retrieve articles.Methods:After screening and diluting out the articles that met inclusion criteria to be used for statistical analysis the pooled evaluation indexes including sensitivity, specificity, and diagnostic odd ratio (DOR) as well as the summary receiver operating characteristic curve (SROC) were calculated involving diagnostic data (true positive, false positive, false negative, and true negative) extracted from original studies.Results:Screening determined that out of 2007, 23 studies involving a total of 524 patients were deemed viable for inclusion in the meta-analysis. The results of the analysis showed that the sensitivity and specificity were at 86% and 80%, respectively. Additionally, a satisfactory accuracy of 18F-FDG PET and PET/CT was observed in detecting ESFT recurrence, lung metastasis, and osseous metastasis.Conclusion:This meta-analysis suggests that 18F-FDG PET and PET/CT with an extremely high accuracy could be considered a valuable method for detecting distant metastasis and post-operational recurrence of ESFT, which might have a profound impact on the development of treatment protocols for ESFT.

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Can FDG-PET/CT replace blind bone marrow biopsy of the posterior iliac crest in Ewing sarcoma?

Cited by 29 publications

References 11 publications

Bone marrow biopsy in the initial staging of Ewing sarcoma: Experience from a single institution

Bone marrow biopsy in the initial staging of Ewing sarcoma: Experience from a single institution

Bone marrow examination in patients with Ewing sarcoma/peripheral primitive neuroectodermal tumor without metastasis based on 18F-fluorodeoxyglucose positron emission tomography/computed tomography

Effectiveness of 18F-FDG PET/CT in the diagnosis, staging and recurrence monitoring of Ewing sarcoma family of tumors

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