The role of bone marrow biopsy and FDG-PET/CT in identifying bone marrow infiltration in the initial diagnosis of high grade non-Hodgkin B-cell lymphoma and Hodgkin lymphoma. Accuracy in a multicenter series of 372 patients.
Bone marrow infiltration (BMI), categorized as an extra-nodal site, affects stage and is associated with poor prognosis in newly diagnosed lymphoma patients. We have evaluated the accuracy of PET/CT and bone marrow biopsy (BMB) to assess BMI in 372 lymphoma patients [140 Hodgkin Lymphoma (HL) and 232 High Grade B-cell non-Hodgkin Lymphoma (HG B-NHL), among them 155 Diffuse Large B-Cell Lymphoma (DLCL)]. For HL cases, and taking into account PET/CT, sensitivity, negative predictive value (NPV) and accuracy were 96.7, 99.3, and 99.3% while those of BMB were 32.3, 83.8, and 85%, respectively. For HG B-NHL and considering PET/CT, sensitivity, NPV, and accuracy were 52.7, 81.7, and 84.1%, while those of BMB were 77.6, 90.2, and 90.7%, respectively. In the HG B-NHL group, 25 patients would have been under-staged without BMB. These results lead us to recommend PET/CT and the avoidance of BMB to assess BMI in HL. In the case of HG B-NHL, bone marrow status should be assessed firstly by means of PET/CT; only in either focal or diffuse PET/CT with low borderline SUV max values or in negative cases, should BMB be carried out afterwards. In the HG B-NHL setting and at the present moment, both techniques are complementary.
S. de Hematología Y Oncología Médica. H.J.M. Morales Meseguer, Murcia, Spain.
Tzu-Hua
TH
Chen-Liang
S. de Hematología. H, Universitario de Canarias, La Laguna, Tenerife, Spain.
Taida
T
Martin-Santos
S. de Hematología Y Oncología Médica. H.J.M. Morales Meseguer, Murcia, Spain.
Andres
A
Jerez
S. de Hematología. H. La Fe, Valencia, Spain.
Leonor
L
Senent
S. de Hematología. H. General, Valencia, Spain.
Maria Teresa
MT
Orero
S. de Hematologia Y Oncología Médica. H, Clínico, Valencia, Spain.
Maria Jose
MJ
Remigia
S. de Hematología. H. R. Méndez, Lorca, Murcia, Spain.
Begoña
B
Muiña
S. de Hematología. H. Sta. Lucia, Cartagena.
Marta
M
Romera
S. de Hematología Y Oncología Médica. H.J.M. Morales Meseguer, Murcia, Spain.
Hermogenes
H
Fernandez-Muñoz
S. de Hematología. H, Universitario de Canarias, La Laguna, Tenerife, Spain.
Jose M
JM
Raya
S. de Hematología. H, Universitario de Canarias, La Laguna, Tenerife, Spain.
Marta
M
Fernandez-Gonzalez
S. de Hematología. H. La Fe, Valencia, Spain.
Aima
A
Lancharro
S. de Hematología. H. General, Valencia, Spain.
Carolina
C
Villegas
S. de Hematologia Y Oncología Médica. H, Clínico, Valencia, Spain.
Juan
J
Carlos Herrera
S. de Medicina Nuclear. H, Virgen de La Arrixaca, Murcia, Spain.
Laura
L
Frutos
S. de Medicina Nuclear. H, Virgen de La Arrixaca, Murcia, Spain.
Jose
J
Luis Navarro
S. de Medicina Nuclear H, Universitario N.S. de La Candelaria, Tenerife, Spain.
Jon
J
Uña
S. de Medicina Nuclear H. La Fe, Valencia, Spain.
Carolina
C
Igua
S. de Medicina Nuclear. H. 9 de Octubre, Valencia, Spain.
Raquel
R
Sanchez-Vaño
S. de Medicina Nuclear. H. General-ERESA, Valencia, Spain.
Maria Del Puig
Mdel P
Cozar
S. de Medcina Nuclear. H, Sta Lucia, Cartagena, Murcia, Spain.
Jose
J
Contreras
S. de Hematología Y Oncología Médica. H.J.M. Morales Meseguer, Murcia, Spain.
Jose Javier
JJ
Sanchez-Blanco
S. de Hematología Y Oncología Médica. H.J.M. Morales Meseguer, Murcia, Spain.
Elena
E
Perez-Ceballos
S. de Hematología Y Oncología Médica. H.J.M. Morales Meseguer, Murcia, Spain.
Francisco Jose
FJ
Ortuño
D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy; D001853:Bone Marrow / Q000473:pathology*; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism; D006689:Hodgkin Disease / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000145:classification / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed
D019788:Fluorodeoxyglucose F18