Prognostic value of bone marrow18F-FDG uptake on PET/CT in lymphoma patients with negative bone marrow involvement.
OBJECTIVE
The study evaluated the significance of 18F fluorodeoxyglucose (18F-FDG) uptake of bone marrow (BM) for predicting progression-free survival (PFS) in lymphoma patients without BM involvement.


METHODS
Ninety-five patients with histopathologically proven lymphoma, 7 Hodgkin's lymphoma and 88 non-Hodgkin's lymphoma, who underwent18F-FDG positron emission tomography/computed tomography (PET/CT) and BM biopsy for staging work-up and 40 normal subjects were retrospectively enrolled. Maximal18F-FDG uptake of lymphoma (Lmax), mean18F-FDG uptake of BM (BM SUV) and BM-to-liver uptake ratio (BLR) were measured. Prognostic value of BM SUV and BLR for predicting PFS were assessed.


RESULTS
Of the 95 patients, 35 (36.8%) were histopathologically or clinically diagnosed with BM involvement of lymphoma. There were significant differences of BLR among lymphoma patients with/without BM involvement and normal subjects (P<0.05). For all patients, high risk indicated by International Prognostic Index (IPI) score and Lmax were significantly associated with PFS on multivariate analysis (P<0.05). For 60 patients without BM involvement, BM SUV and BLR were independent prognostic factors for PFS along with performance status and Lmax (p<0.05). Among patients without BM involvement, high18F-FDG uptake of BM was associated with significantly worse PFS than low18F-FDG uptake of BM, with no significant difference in PFS apparent compared to patients with BM involvement.


CONCLUSIONS
In lymphoma patients without BM involvement,18F-FDG uptake of BM was significantly associated with worse PFS. Patients with high18F-FDG uptake of BM showed similar prognosis to those with BM involvement.
Department of Nuclear Medicine, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Incheon, Korea. gareen@naver.com.
Jeong Won
JW
Lee
Sang Cheol
SC
Lee
Han Jo
HJ
Kim
Sang Mi
SM
Lee
D000328:Adult; D017677:Age Distribution; D000368:Aged; D001853:Bone Marrow / Q000000981:diagnostic imaging* / Q000378:metabolism; D019046:Bone Marrow Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000401:mortality*; D015897:Comorbidity; D018572:Disease-Free Survival; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006801:Humans; D008223:Lymphoma / Q000000981:diagnostic imaging / Q000378:metabolism / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D000072078:Positron Emission Tomography Computed Tomography / Q000706:statistics & numerical data*; D015995:Prevalence; D011379:Prognosis; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D015203:Reproducibility of Results; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D012680:Sensitivity and Specificity; D017678:Sex Distribution; D016019:Survival Analysis
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18