Role of FDG-PET/CT in detecting lymphomatous bone marrow involvement in patients with newly diagnosed diffuse large B-cell lymphoma.
To evaluate the role of FDG-PET/CT in detecting bone marrow (BM) involvement, pre-treatment bilateral bone marrow biopsies (BMBs) and FDG-PET/CT scans of 89 patients with diffuse large B-cell lymphoma (DLBCL) treated with rituximab-CHOP were reviewed and analyzed. Fourteen patients (15.7%) had lymphomatous involvement based on BMB (BMB+), and 17 patients (19.1%) had the possibility of BM involvement on FDG-PET/CT (FDG-PET/CT+). Seventy-two patients (80.8%) had concordant results between BMB and FDG-PET/CT (seven patients were positive for both, and 65 patients were negative for both), but 17 patients (19.2%) had a discordant interpretation (seven patients were BMB+ and FDG-PET/CT-, and ten were BMB- and FDG-PET/CT+). Although BMB+ patients had an inferior 2-year EFS (37.0% vs. 79.8%, p < 0.001) and OS (36.3% vs. 81.0%, p < 0.001) compared to BMB- patients, no differences in EFS (62.6% vs. 72.7%, p = 0.185) and OS (59.4% vs. 78.0%, p = 0.146) were shown between FDG-PET/CT+ and FDG-PET/CT- patients. Whereas six of seven patients with diffuse hypermetabolism were BMB+, only one of ten patients with focal hypermetabolism was BMB+. The results suggest that FDG-PET/CT had a limited value to detect BM involvement in patients with DLBCL. Focal hypermetabolism of hematopoietic BM in FDG-PET/CT had no impact on survival.
Department of Internal Medicine, Gachon University Gil Hospital, Gachon University of Medicine and Science School of Medicine, Incheon, Republic of Korea.
Junshik
J
Hong
Department of Nuclear Medicine, Gachon University Gil Hospital, Gachon University of Medicine and Science School of Medicine, Incheon, Republic of Korea.
Yukyung
Y
Lee
Department of Internal Medicine, Gachon University Gil Hospital, Gachon University of Medicine and Science School of Medicine, Incheon, Republic of Korea.
Yeonjeong
Y
Park
Department of Nuclear Medicine, Gachon University Gil Hospital, Gachon University of Medicine and Science School of Medicine, Incheon, Republic of Korea.
Seog Gyun
SG
Kim
Department of Nuclear Medicine, Gachon University Gil Hospital, Gachon University of Medicine and Science School of Medicine, Incheon, Republic of Korea.
Kyung Hoon
KH
Hwang
Department of Laboratory Medicine, Gachon University Gil Hospital, Gachon University of Medicine and Science School of Medicine, Incheon, Republic of Korea.
Soon Ho
SH
Park
Department of Laboratory Medicine, Gachon University Gil Hospital, Gachon University of Medicine and Science School of Medicine, Incheon, Republic of Korea.
Jihoon
J
Jeong
Department of Laboratory Medicine, Gachon University Gil Hospital, Gachon University of Medicine and Science School of Medicine, Incheon, Republic of Korea.
Kyung-Hee
KH
Kim
Department of Laboratory Medicine, Gachon University Gil Hospital, Gachon University of Medicine and Science School of Medicine, Incheon, Republic of Korea.
Jeong Yeal
JY
Ahn
Department of Pathology, Gachon University Gil Hospital, Gachon University of Medicine and Science School of Medicine, Incheon, Republic of Korea.
Sanghui
S
Park
Department of Internal Medicine, Gachon University Gil Hospital, Gachon University of Medicine and Science School of Medicine, Incheon, Republic of Korea.
Jinny
J
Park
Department of Internal Medicine, Gachon University Gil Hospital, Gachon University of Medicine and Science School of Medicine, Incheon, Republic of Korea. jhlee@gilhospital.com.
Jae Hoon
JH
Lee
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001853:Bone Marrow / Q000473:pathology; D019046:Bone Marrow Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000556:secondary*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D011379:Prognosis; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed
D019788:Fluorodeoxyglucose F18