The utility of 18-F-fluorodeoxyglucose positron emission tomography in evaluation of bone marrow involvement by non-Hodgkin lymphoma.
OBJECTIVE
In non-Hodgkin lymphomas (NHLs), the bone marrow (BM) involvement is a sign of extensive disease and the iliac crest BM biopsy (BMB) is the established method for the detection of BM infiltration. However, iliac crest BMB is associated with a high rate of false negative results. We assess the ability of 18-F-fluorodeoxyglucose positron emission tomography (F-FDG PET) scan to ascertain the presence of BM involvement in NHL.


METHODS
After reviewing charts of histologically proven NHLs, 97 patients were eligible for our study. All patients were examined by whole-body F-FDG PET scan for initial staging, and all had unilateral posterior iliac crest BMB. BM involvement was established after the result of unilateral posterior iliac crest BMB and image-guided BMB after positive F-FDG PET scan in selected patients.


RESULTS
Our data demonstrate an overall sensitivity of 79% for the F-FDG PET scan detecting BM involvement in all patients and specificity of 91%. Further analysis revealed no significant difference in the ability of the F-FDG PET scan to detect BM involvement between the indolent-NHL and the aggressive/highly aggressive-NHL groups (sensitivity P = 0.23, specificity P = 0.64).


CONCLUSIONS
F-FDG PET scan shows potential to detect BM involvement in NHL. In particular, image-guided repeat BMB should be considered in patients with negative initial iliac crest BMB, whose F-FDG PET scan demonstrates BM involvement in a different site.
Department of Internal Medicine, Cleveland Clinic at Fairview Hospital, Cleveland, OH 44111, USA. alaf73@yahoo.com
Alaa A
AA
Muslimani
Hany L
HL
Farag
Smitha
S
Francis
Timothy P
TP
Spiro
Asif A
AA
Chaudhry
Vincent C
VC
Chan
Harris C
HC
Taylor
Hamed A
HA
Daw
D000328:Adult; D000368:Aged; D001853:Bone Marrow / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods / Q000706:statistics & numerical data*; D011379:Prognosis; D019275:Radiopharmaceuticals; D012189:Retrospective Studies
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18