Italian Multicenter Study on Accuracy of 18 F-FDG PET/CT in Assessing Bone Marrow Involvement in Pediatric Hodgkin Lymphoma

Cistaro, Angelina; Cassalia, Laura; Ferrara, Cinzia; Quartuccio, Natale; Evangelista, Laura; Bianchi, Maurizio; Bisi, G; Baldari, Sergio; Zanella, Alessandro; Pillon, Marta; Zucchetta, Pietro; Burei, Marta; Sala, Alessandra; Guerra, Luca; Guglielmo, Priscilla; Burnelli, Roberta; Panareo, Stefano; Scalorbi, Federica; Rambaldi, Ilaria; Piccardo, Arnoldo; Garaventa, Alberto; Familiari, Demetrio; Fornito, Maria Concetta; Lopci, Egesta; Mascarin, Maurizio; Altini, Corinna; Ferrari, Cristina; Perillo, Teresa; Santoro, Nicola; Borsatti, Eugenio; Rubini, Giuseppe

doi:10.1016/j.clml.2018.04.002

Cited by 16 publications

(11 citation statements)

References 46 publications

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“…Our results showed a higher sensitivity of PET/CT 94.1% (95% CI, 81.6-100) in detection of BMI compared to BMB 35.3% (95% CI, 10-60.6). This is consistent with the study done by Cistaro et al [28], the sensitivity of 18F-FDG PET/CT was found 96% (95% CI, 89-100%) while that of BMB was found 38% (95% CI, 20-57%). This is also consistent with the study done by Büyükşimşek et al [29], who included 110 patients with HL and found PET/CT sensitivity was 91.3% (95% CI, 71.96-98.93) compared to that of BMB which was 56.52% (95% CI, 34.49-76.81).…”

Section: Discussionsupporting

confidence: 93%

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PET/CT and bone marrow biopsy (BMB) in evaluating bone marrow in lymphoma

Elamir

Elazab

Owis

et al. 2020

Egypt J Radiol Nucl Med

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Background Bone marrow assessment is an important part in the Ann Arbor staging system in lymphoma. It is done routinely through posterior iliac crest bone marrow biopsy (BMB) which is an invasive technique with limited examination of one site. 18F-FDG PET/CT is now used for staging of lymphoma. The purpose of this study was to compare the sensitivity of PET/CT and BMB in detecting bone marrow infiltration (BMI) in lymphoma and determine agreement between both in assessing bone marrow and whether we can evaluate the bone marrow by PET/CT without the need of the routine BMB. Results PET/CT detected 24 (16.5%) cases with positive BMI that were missed by BMB. BMB detected only 2 (1.4%) cases that were missed by PET/CT. The PET/CT showed a higher sensitivity of 95.6% than BMB 46.7% in detecting BMI in lymphoma. We found a moderate agreement between PET/CT and BMB results in the whole cohort using Cohen’s k computation. It was found that 0.47 with p value less than 0.0001. Conclusions PET/CT can detect more bone marrow involvement in lymphoma compared with BMB. It can replace the routine invasive BMB in many cases, especially those showing multifocal uptake in both Hodgkin and non-Hodgkin lymphoma. PET/CT can also help to guide the site of the biopsy in some cases. Iliac crest BMB is still needed in cases showing diffuse FDG uptake to differentiate malignant uptake from reactive hyperplasia, and in those with limited FDG avidity and in some cases with negative uptake to exclude early infiltration if management will differ.

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Section: Discussionsupporting

confidence: 93%

“…In our study, we found a fair agreement between PET/ CT and BMB in HL cases by using Cohen's k, it was found 0.350 with p value less than 0.0001. This is consistent with the study done by Cistaro et al [28], who found also fair agreement between PET/CT and BMB findings as Cohen's k was found 0.398 with p value less than 0.001.…”

Section: Discussionsupporting

confidence: 92%

PET/CT and bone marrow biopsy (BMB) in evaluating bone marrow in lymphoma

Elamir

Elazab

Owis

et al. 2020

Egypt J Radiol Nucl Med

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“…Bone marrow examination (marrow aspirate and trephine) is no longer routinely performed in the FDG-PET era. 3,4 Where PET imaging is unavailable for diagnostic staging, bone marrow examination may be considered for patients especially, for those with advanced-stage NLPHL identified on conventional cross-sectional imaging and/or adverse high-risk factors.…”

Section: Other Pre-treatment Investigationsmentioning

confidence: 99%

Management of children and adults with all stages of nodular lymphocyte predominant Hodgkin lymphoma — All StAGEs: A consensus‐based position paper from the Hodgkin lymphoma subgroup of the UK National Cancer Research Institute

et al. 2022

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Summary A consensus statement for the management for patients of all ages with all stages of nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) — All StAGEs — is proposed by representatives of the UK National Cancer Research Institute (NCRI) Hodgkin lymphoma study group and the Children's Cancer & Leukaemia Group. Based on current practices and published evidence, a consensus has been reached regarding diagnosis, staging and risk‐ik7 stratified management which includes active surveillance, low‐ and standard‐dose immunochemotherapy and radiotherapy.

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“…Indeed, a direct association has been shown between bone marrow glucose uptake and host systemic inflammation in cancer patients [ 259 ]. Furthermore, a diffusedly increased bone marrow FDG uptake can be present in patients due to increased hematopoiesis following administration of granulocyte-colony stimulating factors [ 260 ].…”

Section: Resultsmentioning

confidence: 99%

State of the art of 18F-FDG PET/CT application in inflammation and infection: a guide for image acquisition and interpretation

Casali

Lauri

Altini

et al. 2021

Clin Transl Imaging

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Aim The diagnosis, severity and extent of a sterile inflammation or a septic infection could be challenging since there is not one single test able to achieve an accurate diagnosis. The clinical use of 18F-fluorodeoxyglucose ([ 18 F]FDG) positron emission tomography/computed tomography (PET/CT) imaging in the assessment of inflammation and infection is increasing worldwide. The purpose of this paper is to achieve an Italian consensus document on [ 18 F]FDG PET/CT or PET/MRI in inflammatory and infectious diseases, such as osteomyelitis (OM), prosthetic joint infections (PJI), infective endocarditis (IE), prosthetic valve endocarditis (PVE), cardiac implantable electronic device infections (CIEDI), systemic and cardiac sarcoidosis (SS/CS), diabetic foot (DF), fungal infections (FI), tuberculosis (TBC), fever and inflammation of unknown origin (FUO/IUO), pediatric infections (PI), inflammatory bowel diseases (IBD), spine infections (SI), vascular graft infections (VGI), large vessel vasculitis (LVV), retroperitoneal fibrosis (RF) and COVID-19 infections. Methods In September 2020, the inflammatory and infectious diseases focus group (IIFG) of the Italian Association of Nuclear Medicine (AIMN) proposed to realize a procedural paper about the clinical applications of [ 18 F]FDG PET/CT or PET/MRI in inflammatory and infectious diseases. The project was carried out thanks to the collaboration of 13 Italian nuclear medicine centers, with a consolidate experience in this field. With the endorsement of AIMN, IIFG contacted each center, and the pediatric diseases focus group (PDFC). IIFG provided for each team involved, a draft with essential information regarding the execution of [ 18 F]FDG PET/CT or PET/MRI scan (i.e., indications, patient preparation, standard or specific acquisition modalities, interpretation criteria, reporting methods, pitfalls and artifacts), by limiting the literature research to the last 20 years. Moreover, some clinical cases were required from each center, to underline the teaching points. Time for the collection of each report was from October to December 2020. Results Overall, we summarized 291 scientific papers and guidelines published between 1998 and 2021. Papers were divided in several sub-topics and summarized in the following paragraphs: clinical indications, image interpretation criteria, future perspectivess and new trends (for each single disease), while patient preparation, image acquisition, possible pitfalls and

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Italian Multicenter Study on Accuracy of 18 F-FDG PET/CT in Assessing Bone Marrow Involvement in Pediatric Hodgkin Lymphoma

Abstract: F-FDG PET/CT showed high diagnostic performance in the evaluation of BMI in pediatric HL. Thus, BMB should be ideally reserved for patients presenting with doubtful F-FDG PET/CT findings for BMI.

Cited by 16 publications

References 46 publications

PET/CT and bone marrow biopsy (BMB) in evaluating bone marrow in lymphoma

PET/CT and bone marrow biopsy (BMB) in evaluating bone marrow in lymphoma

Management of children and adults with all stages of nodular lymphocyte predominant Hodgkin lymphoma — All StAGEs: A consensus‐based position paper from the Hodgkin lymphoma subgroup of the UK National Cancer Research Institute

State of the art of 18F-FDG PET/CT application in inflammation and infection: a guide for image acquisition and interpretation

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