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

被引:16
作者
Hao, Bing
Zhao, Long
Luo, Na-na
Ruan, Dan
Pang, Yi-zhen
Guo, Wei
Fu, Hao
Guo, Xiu-yu
Luo, Zuo-ming
Wu, Jing
Chen, Hao-jun
Wu, Hua
Sun, Long [1 ]
机构
[1] Xiamen Univ, Affiliated Hosp 1, Xiamen Canc Hosp, Dept Nucl Med, 55 Zhenhai Rd, Xiamen 361003, Fujian, Peoples R China
基金
中国国家自然科学基金;
关键词
Lymphomas; Bone marrow involvement; F-18-FDG PET; CT; Bone marrow biopsy; POSITRON-EMISSION-TOMOGRAPHY; FDG UPTAKE; CLINICAL-SIGNIFICANCE; HODGKINS; LESIONS; DISEASE; CANCER; PERFORMANCE; MALIGNANCY; SAFE;
D O I
10.1186/s12885-018-5104-0
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
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 F-18-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 F-18-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 F-18-FDG PET/CT and routine iliac crest biopsy. F-18-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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页数:11
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