title: F-18 FDG PET for evaluation of bone marrow involvement in non-Hodgkin lymphoma: a meta-analysis.
abstract: BACKGROUND
  In recent years, the use of F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) has become widespread for the staging of lymphoma. In non-Hodgkin lymphoma (NHL), 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 FDG PET or PET/CT scan to ascertain the presence of BM involvement in aggressive and indolent NHL.
  
  
  METHODS
  The authors conducted a systematic MEDLINE search of articles published (last update, May 2010). Two reviewers independently assessed the methodological quality of each study. A meta-analysis of the reported sensitivity and specificity of each study was performed.
  
  
  RESULTS
  Eight studies met the inclusion criteria. The studies had several design deficiencies. Pooled sensitivity and specificity for the detection of non-Hodgkin aggressive lymphoma were 0.74 (95% CI, 0.65-0.83) and 0.84 (95% CI, 0.80-0.89), respectively. Pooled sensitivity and specificity for the detection of non-Hodgkin indolent lymphoma were 0.46 (95% CI, 0.33-0.59) and 0.93 (95% CI, 0.88-0.98), respectively.
  
  
  CONCLUSIONS
  The diagnostic accuracy of FDG PET or PET/CT scans was slightly higher but without significant statistical difference (P = 0.1507) in patients with non-Hodgkin aggressive lymphoma as compared with those with non-Hodgkin indolent lymphoma. The sensitivity to detect indolent lymphoma BM infiltration was low for FDG PET or PET/CT.
authors.affiliation: Department of Nuclear Medicine and PET Center, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
authors.forename: Yen-Kung
authors.initials: YK
authors.lastname: Chen
authors.forename: Chia-Lu
authors.initials: CL
authors.lastname: Yeh
authors.forename: Chih-Cheng
authors.initials: CC
authors.lastname: Tsui
authors.forename: Ji-An
authors.initials: JA
authors.lastname: Liang
authors.forename: Jin-Hua
authors.initials: JH
authors.lastname: Chen
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Kao
mesh_terms: D001853:Bone Marrow / Q000000981:diagnostic imaging*; D005069:Evaluation Studies as Topic; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography; D011785:Quality Assurance, Health Care; D012372:ROC Curve; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
chemical_list: D019788:Fluorodeoxyglucose F18