title: Evaluation of bone marrow involvement in extranodal NK/T cell lymphoma by FDG-PET/CT.
abstract: Evaluation of bone marrow involvement (BMI) by conventional bone marrow biopsy (BMB) can generate false-negative results if marrow disease is focal. The sensitivity of 18F-2-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (FDG-PET/CT) in assessing BMI in extranodal NK/T cell lymphoma (ENKL) has not been determined. We retrospectively collected clinical data from a series of 55 patients with newly diagnosed ENKL, who have received both FDG-PET/CT and BMB prior to treatment. BMB results were used as reference standard. Twelve patients (21.8 %) were considered positive lymphomatous infiltration by FDG-PET/CT (PET-CT/BM+), and five patients (9 %) were identified positive by BMB (BMB/BM+). There was a discordant result in seven patients who were PET-CT/BM+ but BMB/BM-. The sensitivity and specificity of FDG-PET/CT for identifying BMI were 100 and 86 %, respectively. Then, we analyzed the overall survival (OS) and progression-free survival (PFS) of patients who were PET-CT/BM+ and PET-CT/BM-. The median follow-up time was 16 months (range, 3 to 43 months). PET-CT/BM+ patients possessed worse 2-year OS than PET-CT/BM- patients (84.8 vs 67.9 %, P < 0.05). The estimated 2-year PFS for PET-CT/BM- and PET-CT/BM+ patients were 72.7 and 41.9 % (P < 0.05), respectively. However, it was hard to conclude that patients who were PET-CT/BM+ had similar survivals to advanced-stage patients due to the low number of patients who were PET-CT/BM+. In conclusion, FDG-PET/CT can complementally detect positive BMI patients missed by BMB in ENKL. The utility of FDG-PET/CT for defining bone marrow status has important prognostic value.
authors.affiliation: Department of Oncology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou, 450000, China.
authors.forename: Zhiyuan
authors.initials: Z
authors.lastname: Zhou
authors.forename: Changying
authors.initials: C
authors.lastname: Chen
authors.forename: Xiang
authors.initials: X
authors.lastname: Li
authors.forename: Zhaoming
authors.initials: Z
authors.lastname: Li
authors.forename: Xudong
authors.initials: X
authors.lastname: Zhang
authors.forename: Yu
authors.initials: Y
authors.lastname: Chang
authors.forename: Lisha
authors.initials: L
authors.lastname: Lu
authors.forename: Yingying
authors.initials: Y
authors.lastname: Cui
authors.forename: Yaozhen
authors.initials: Y
authors.lastname: Ma
authors.forename: Mingzhi
authors.initials: M
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001853:Bone Marrow / Q000000981:diagnostic imaging*; D018572:Disease-Free Survival; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D054391:Lymphoma, Extranodal NK-T-Cell / Q000000981:diagnostic imaging* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D049268:Positron-Emission Tomography / Q000379:methods; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods; D055815:Young Adult
chemical_list: D019788:Fluorodeoxyglucose F18