Can Positron Emission Tomography and Computed Tomography Be a Substitute for Bone Marrow Biopsy in Detection of Bone Marrow Involvement in Patients with Hodgkin's or Non-Hodgkin's Lymphoma?
Positron emission tomography and computed tomography (PET/CT) has become an important part of staging and treatment evaluation algorithms of lymphoma. We aimed to compare the results of PET/CT with bone marrow biopsy (BMB) with respect to bone marrow involvement (BMI) in patients with Hodgkin's lymphoma (HL) and aggressive non-Hodgkin's lymphoma (aNHL).



The medical files of a total of 297 patients diagnosed with HL or aNHL and followed at the hematology clinics of 3 major hospitals in İstanbul between 2008 and 2012 were screened retrospectively and 161 patients with classical HL and aNHL were included in the study. The patients were referred for PET/CT and BMB at the initial staging. BMB was performed as the reference standard for the evaluation of BMI.



There were 61 (38%) HL and 100 (62%) aNHL patients. Concordant results were revealed between PET/CT and BMB in 126 patients (78%) (52 HL, 74 aNHL), 20 with positive PET/CT and BMB results and 106 with negative PET/CT and BMB results. There were discordant results in 35 patients (9 HL, 26 aNHL), 16 of them with positive BMB and negative PET/ CT results and 19 of them with negative BMB and positive PET/CT results.



We observed that PET/CT is effective to detect BMI, despite it alone not being sufficient to evaluate BMI in HL and aNHL. Bone marrow trephine biopsy and PET/CT should be considered as mutually complementary methods for detection of BMI in patients with lymphoma. In suspected focal involvement, combining biopsy and PET/CT might improve staging results.
Güven
G
Çetin
M Ali
MA
Çıkrıkçıoğlu
Tuba
T
Özkan
Cumali
C
Karatoprak
M Cem
MC
Ar
Ahmet Emre
AE
Eşkazan
Mesut
M
Ayer
Abdullah
A
Cerit
Kübra
K
Gözübenli
Betül Börkü
BB
Uysal
Simge
S
Erdem
Nurhan
N
Ergül
Gamze
G
Tatar
T Fikret
TF
Çermik
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001853:Bone Marrow / Q000000981:diagnostic imaging* / Q000473:pathology; D001856:Bone Marrow Examination; D005260:Female; D006689:Hodgkin Disease / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D000072078:Positron Emission Tomography Computed Tomography; D015203:Reproducibility of Results; D012189:Retrospective Studies; D055815:Young Adult