Can Positron Emission Tomography and Computed Tomography Be a Substitute for Bone Marrow Biopsy in Detection of Bone Marrow Involvement in Patients with Hodgkin’s or Non-Hodgkin’s Lymphoma?

Çetin, Güven; Çıkrıkçıoğlu, Mehmet Ali; Özkan, Tuba; Karatoprak, Cumali; Ar, Muhlis Cem; Eşkazan, Ahmet Emre; Ayer, Mesut; Cerit, Abdullah; Gözübenli, Kübra; Uysal, Betül Börkü; Erdem, Simge; Ergül, Nurhan; Tatar, Gamze; Çermik, Tevfik Fikret

doi:10.4274/tjh.2013.0336

Cited by 3 publications

(2 citation statements)

References 29 publications

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“…Statistically significant concordance was found between PET/CT and BMB according to BMI in both patient groups. As in the study conducted by Çetin G et al [20], concordance in the HL patient group was stronger than in the NHL patient group. Looking at the whole patient group and subgroups of NHL, we find quite interesting results.…”

Section: Discussionsupporting

confidence: 62%

Performance of Positron Emission Tomography-Computed Tomography and Bone Marrow Biopsy in Detecting Bone Marrow Infiltration in Lymphoma Cases

Büyükşimşek

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Yetisir

et al. 2020

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Amaç: Kemik iliği infiltrasyonu (Kİİ), lenfoma evresini, sağkalımı ve tedaviyi etkiler. Lenfoma hastalarında Kİİ' ni saptamada kemik iliği biyopsisi (KİB) ve positron emisyon tomografi-bilgisayarlı tomografi (PET/BT)' nin performanslarını değerlendirmek istedik. Gereç veYöntemler: 269 non-Hodgkin lenfoma (NHL) ve 110 hodgkin lenfoma (HL) hastası retrospektif olarak değerlendirildi. Kİİ' ni saptamada PET/BT ve KİB için duyarlılık, negatif prediktif değer (NPD) ve doğruluk hesaplandı. Bulgular: NHL olgularında Kİİ' ni saptamada PET/BT için duyarlılık, NPD ve doğruluk sırasıyla %65, %78 ve %84.4 iken KİB için %55, %73.4 ve %79.9 idi. Diffüz büyük B hücreli lenfoma ve folliküler lenfoma için PET/BT performansı KİB' den daha iyi iken; mantle-cell lenfoma, burkitt's lenfoma ve primer mediastinal B hücreli lenfomada KİB performansı daha iyiydi. HL olgularında PET/BT için duyarlılık, NPD ve doğruluk sırasıyla %91.3, %97.75 ve %98.18 iken KİB için %56.52, %89.69 ve %90.91 idi. KİB yapılması ile NHL grubunda 43 (%15.9), HL grubunda ise 2 (%1.8) olgunun düşük evrelenmesinden korunmuş olundu. Sonuç: Kİİ' ni saptamada NHL alt tiplerine göre değişmekle birlikte PET/BT ve KİB birbirini tamamlayıcı yöntemlerdir. HL' de ise Kİİ' ni saptamak için PET/BT önemli bir tanı aracıdır ve KİB olguların önemli kısmında gerekli değildir. Anahtar Sözcükler: Lenfoma, kemik iliği infiltrasyonu, PET/BT, kemik iliği biyopsisiObjective: Bone marrow infiltration (BMI) affects the stage of lymphoma, survey, and treatment. We aimed to evaluate the performance of bone marrow biopsy (BMB) and positron emission tomography-computed tomography (PET/CT) in detecting bone marrow infiltration in lymphoma patients. Materials and Methods: 269 non-Hodgkin's lymphoma (NHL) and110 Hodgkin's lymphoma (HL) patients were evaluated retrospectively. Sensitivity, negative predictive value (NPV) and accuracy were calculated for PET/CT and BMB in detecting BMI.Results: Sensitivity, NPV and accuracy for PET/CT in detecting BMI in NHL cases were 65%, 78% and 84.4%, respectively, while 55%, 73.4% and 79.9% for BMB. PET/CT performance for diffuse large B-cell lymphoma and follicular lymphoma was better than BMB, whereas the performance of BMB was better for mantle-cell lymphoma, Burkitt's lymphoma and primary mediastinal B-cell lymphoma. Sensitivity, NPV and accuracy for PET-CT in HL cases were 91.3%, 97.75% and 98.18%, respectively, while 56.52%, 89.69% and 90.91% for BMB. Due to BMB, 43 (15.9%) patients in the NHL group and 2 (1.8%) patients in the HL group were protected from downstaging. Conclusion:PET/CT and BMB, although their results vary according to the NHL subtypes, are complementary methods in determining the BMI. In HL, PET/CT is an important diagnostic tool for detecting BMI, and BMB is not necessary in a significant proportion of cases. Turk J Hematol 2020;37:220-225 Büyükşimşek et al: Lymphoma and Bone Marrow Infiltration Öz Abstract

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Section: Discussionsupporting

confidence: 62%

Performance of Positron Emission Tomography-Computed Tomography and Bone Marrow Biopsy in Detecting Bone Marrow Infiltration in Lymphoma Cases

Büyükşimşek

Kolsuz

Yetisir

et al. 2020

Tjh

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“…This systematic review involved some limitations. In some studies PET/CT images were interpreted using qualitative criteria [15][16][17]19,20,22,26,29,31,[34][35][36][37][38][39]42,43,47,48,50,[52][53][54], whereas in other studies both qualitative and quantitative criteria were used [18,21,[23][24][25]27,28,30,32,33,40,41,[44][45][46]49,51,55]. As the qualitative evaluation is based on a subject's experience, this might underestimate the PET/CT diagnostic performance.…”

Section: Discussionmentioning

confidence: 99%

FDG PET/CT versus Bone Marrow Biopsy for Diagnosis of Bone Marrow Involvement in Non-Hodgkin Lymphoma: A Systematic Review

et al. 2022

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The management of non-Hodgkin lymphoma (NHL) patients requires the identification of bone marrow involvement (BMI) using a bone marrow biopsy (BMB), as recommended by international guidelines. Multiple studies have shown that [18F]FDG positron emission tomography, combined with computed tomography (PET/CT), may provide important information and may detect BMI, but there is still an ongoing debate as to whether it is sensitive enough for NHL patients in order to replace or be used as a complimentary method to BMB. The objective of this article is to systematically review published studies on the performance of [18F]FDG PET/CT in detecting BMI compared to the BMB for NHL patients. A population, intervention, comparison, and outcome (PICO) search in PubMed and Scopus databases (until 1 November 2021) was performed. A total of 41 studies, comprising 6147 NHL patients, were found to be eligible and were included in the analysis conducted in this systematic review. The sensitivity and specificity for identifying BMI in NHL patients were 73% and 90% for [18F]FDG PET/CT and 56% and 100% for BMB. For aggressive NHL, the sensitivity and specificity to assess the BMI for the [18F]FDG PET/CT was 77% and 94%, while for the BMB it was 58% and 100%. However, sensitivity and specificity to assess the BMI for indolent NHL for the [18F]FDG PET/CT was 59% and 85%, while for the BMB it was superior, and equal to 94% and 100%. With regard to NHL, a [18F]FDG PET/CT scan can only replace BMB if it is found to be positive and if patients can be categorized as having advanced staged NHL with high certainty. [18F]FDG PET/CT might recover tumors missed by BMB, and is recommended for use as a complimentary method, even in indolent histologic subtypes of NHL.

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Is it sufficient to evaluate bone marrow involvement in newly diagnosed lymphomas using 18F-FDG PET/CT and/or routine iliac crest biopsy? A new approach of PET/CT-guided targeted bone marrow biopsy

et al. 2018

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BackgroundTo investigate whether PET/CT-guided bone marrow biopsy adds complementary information for evaluation of bone marrow involvement (BMI) in newly diagnosed lymphomas.MethodsPatients with newly diagnosed lymphomas that received both 18F-FDG PET/CT and bone marrow biopsy (BMB) were included in this retrospective study. PET/CT classification of bone lesions was classified as isolated, multifocal (2 lesions or more), diffuse (homogeneous uptake of the entire axial skeleton), or negative. BMBs included PET/CT-guided targeted BMB and/or the routine unilateral iliac crest biopsy. Of 34 patients with focal lesions on PET/CT scan, 30 received both PET/CT-guided targeted BMB and iliac crest biopsy, and 4 patients received targeted biopsy without iliac crest biopsy. The final diagnosis of BMI depends on BMB results.ResultsA total of 299 patients with lymphomas were included. PET/CT classification of bone lesions was isolated (16/5.4%), multifocal (67/22.4%), diffuse (52/17.4%), and negative (164/54.8%). If only positive iliac crest biopsy was considered as the reference standard, the sensitivity of 18F-FDG PET/CT for identifying focal and diffuse BMI was 48 and 56%, respectively, and the respective specificities were 70 and 83%. Three of 30 patients (10.0%) with focal lesions on PET/CT were confirmed to be false-positive by targeted BMB, and 25 of 30 patients (83.3%) with focal lesions on PET/CT were confirmed as false-negative by iliac crest biopsy.ConclusionIt is insufficient to evaluate BMI in newly diagnosed lymphomas using both 18F-FDG PET/CT and routine iliac crest biopsy. 18F-FDG PET/CT imaging should be performed before BMB. In focal bone lesions, PET/CT-guided targeted BMB may complement the results of possible false-positive PET/CT and false-negative iliac crest biopsy findings. However, in diffuse and negative lesions, iliac crest biopsy cannot be safely omitted.

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Can Positron Emission Tomography and Computed Tomography Be a Substitute for Bone Marrow Biopsy in Detection of Bone Marrow Involvement in Patients with Hodgkin’s or Non-Hodgkin’s Lymphoma?

Cited by 3 publications

References 29 publications

Performance of Positron Emission Tomography-Computed Tomography and Bone Marrow Biopsy in Detecting Bone Marrow Infiltration in Lymphoma Cases

Performance of Positron Emission Tomography-Computed Tomography and Bone Marrow Biopsy in Detecting Bone Marrow Infiltration in Lymphoma Cases

FDG PET/CT versus Bone Marrow Biopsy for Diagnosis of Bone Marrow Involvement in Non-Hodgkin Lymphoma: A Systematic Review

Is it sufficient to evaluate bone marrow involvement in newly diagnosed lymphomas using 18F-FDG PET/CT and/or routine iliac crest biopsy? A new approach of PET/CT-guided targeted bone marrow biopsy

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