Use of FDG PET/CT in identification of bone marrow involvement in diffuse large B cell lymphoma and follicular lymphoma: comparison with iliac crest bone marrow biopsy

Teagle, Alexandra R; Barton, H.J.; Charles-Edwards, Elizabeth; Dizdarevic, Sabina; Chevassut, Timothy

doi:10.1177/0284185117701305

Cited by 31 publications

(25 citation statements)

References 26 publications

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“…PET/CT is highly sensitive in demonstrating bone marrow focal involvement in patients with aggressive NHL and HL. As previously described, PET/CT was considered positive when there was focal or multifocal bone marrow or bone involvement [11]. Diffuse bone marrow involvement in PET/CT was not considered positive because it may be due to inflammation or benign causes [12,13].…”

Section: F Fdg Pet/ctmentioning

confidence: 99%

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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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: F Fdg Pet/ctmentioning

confidence: 99%

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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“…The presence of BMI can change the treatment strategy, especially in patients who were thought to have early-stage disease prior to having a bone assessment. 18 F-fluorodesoxyglucose ( 18 FDG) positron emission tomography (PET)/computed tomography (CT) is now used for the assessment of BMI in HL patients 7 , 8 and DLBCL patients 9 – 13 . Indeed, several studies have demonstrated sufficient diagnostic performances for these two histologic subtypes of lymphoma.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic value of baseline 18FDG PET/CT skeletal textural features in follicular lymphoma

Faudemer

Aide

Gac

et al. 2021

Sci Rep

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At present, 18F-fluorodesoxyglucose (18FDG) positron emission tomography (PET)/computed tomography (CT) cannot be used to omit a bone marrow biopsy (BMB) among initial staging procedures in follicular lymphoma (FL). The additional diagnostic value of skeletal textural features on baseline 18FDG-PET/CT in diffuse large B-cell lymphoma (DLBCL) patients has given promising results. The aim of this study is to evaluate the value of 18FDG-PET/CT radiomics for the diagnosis of bone marrow involvement (BMI) in FL patients. This retrospective bicentric study enrolled newly diagnosed FL patients addressed for baseline 18FDG PET/CT. For visual assessment, examinations were considered positive in cases of obvious bone focal uptakes. For textural analysis, the skeleton volumes of interest (VOIs) were automatically extracted from segmented CT images and analysed using LifeX software. BMB and visual assessment were taken as the gold standard: BMB −/PET − patients were considered as bone-NEGATIVE patients, whereas BMB +/PET −, BMB −/PET + and BMB +/PET + patients were considered bone-POSITIVE patients. A LASSO regression algorithm was used to select features of interest and to build a prediction model. Sixty-six consecutive patients were included: 36 bone-NEGATIVE (54.5%) and 30 bone-POSITIVE (45.5%). The LASSO regression found variance_GLCM, correlation_GLCM, joint entropy_GLCM and busyness_NGLDM to have nonzero regression coefficients. Based on ROC analysis, a cut-off equal to − 0.190 was found to be optimal for the diagnosis of BMI using PET pred.score. The corresponding sensitivity, specificity, PPV and NPV values were equal to 70.0%, 83.3%, 77.8% and 76.9%, respectively. When comparing the ROC AUCs with using BMB alone, visual PET assessment or PET pred.score, a significant difference was found between BMB versus visual PET assessments (p = 0.010) but not between BMB and PET pred.score assessments (p = 0.097). Skeleton texture analysis is worth exploring to improve the performance of 18FDG-PET/CT for the diagnosis of BMI at baseline in FL patients.

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“…We recently reported that the incidence and pattern of bone involvement detected by positron emission tomography (PET)/computed tomography (CT) is also associated with early clinical failure in untreated FL [10]. Unlike in diffuse large B-cell lymphoma or Hodgkin lymphoma, where PET/CT has been demonstrated to be accurate enough to obviate the routine need for BMB, there is no such evidence in FL [11][12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Fluorodeoxyglucose-Positron Emission Tomography Predicts Bone Marrow Involvement in the Staging of Follicular Lymphoma

et al. 2020

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Background. Standard bone marrow biopsy (BMB) and bone involvement with follicular lymphoma (FL) on positron emission tomography (PET)/computed tomography (CT) both predict early clinical failure in FL. The key clinical question is whether PET/CT findings can obviate the need for BMB. The goal of this study was to determine the value of PET/CT in determining bone involvement in FL, using posterior iliac crest BMB as the gold standard. Materials and Methods. A total of 548 patients with newly diagnosed grade 1-3A FL were included. The presence, pattern, and location of bone involvement, spleen involvement, and standardized uptake values (SUVs) in the L3 vertebral body were recorded for all patients and compared with the BMB report. Results. Excluding patients with focal bone lesions on PET/CT, the sensitivity and specificity of PET/CT in detecting bone or marrow involvement, compared with BMB, were 53% and 88%, respectively. The sensitivity and specificity of spleen involvement on PET/CT in predicting a positive BMB were 55% and 86%, respectively. An L3 SUV max of less than 2.0 resulted in a negative predictive value (NPV) of 96% for marrow involvement on BMB; an L3 SUV mean below 1.4 resulted in an NPV of 100%. Conclusion. In newly diagnosed FL, PET/CT-detected bone and splenic involvement is highly specific for a positive BMB, and very low SUV values (<2.0 SUV max and < 1.4 SUV mean ) in the lumbar spine have a high NPV for a negative BMB. Routine BMB may be obviated in these patients. BMB remains necessary to definitively exclude bone marrow involvement in a large majority of patients with a negative PET.

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Use of FDG PET/CT in identification of bone marrow involvement in diffuse large B cell lymphoma and follicular lymphoma: comparison with iliac crest bone marrow biopsy

Cited by 31 publications

References 26 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

Diagnostic value of baseline 18FDG PET/CT skeletal textural features in follicular lymphoma

Fluorodeoxyglucose-Positron Emission Tomography Predicts Bone Marrow Involvement in the Staging of Follicular Lymphoma

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