Aim: To define the role of F-flourodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) in the detection of bone marrow (BM) involvement in patients with diffuse large B cell lymphoma (DLBCL).
Materials And Methods: Fifty-four (mean age: 55.5 ± 18.3 years, 20 female and 34 male) DLBCL patients who underwent pretreatment F-FDG PET/CT were included to the study. Focal or diffuse BM F-FDG uptake that is higher than mediastinal blood pool uptake was accepted as positive. After staging of disease by CT and F-FDG PET/CT, all the patients received R-CHOP treatment after diagnostic blinded bone marrow biopsy (BMB). Presence of positive BM uptake in F-FDG PET/CT and histopathological examination results of BMBs were analyzed by Chi-square test. Sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of F-FDG PET/CT in the detection of BM involvement were calculated. Prognostic importance of the presence of BM F-FDG uptake was analyzed by Kaplan-Meier analysis.
Results: BM F-FDG uptake was detected in 8 patients. Histopathological examination of BMB revealed BM involvement in 6 out of 8 patients. BMB was negative in all patients who have no F-FDG uptake in the evaluation of PET/CT images. Sensitivity, specificity, accuracy, PPV, and NPV of F-FDG PET/CT in the detection of BM involvement were calculated as 100%, 96%, 96%, 75%, and 100%, respectively. In the Kaplan-Meier analysis, we found that presence of pretreatment F-FDG uptake in BM has a prognostic importance. Whereas mean time to progression (TTP) in patients with BM uptake was 32.25 ± 10.9 months and mean TTP in those without was 51.69 ± 3.6 months (p = 0.013).
Conclusions: BM uptake in pretreatment F-FDG PET/CT is an important prognostic factor in DLBCL patients. Moreover, in consideration of high NPV, F-FDG PET/CT could eliminate unnecessary BMB in FDG-negative patients.
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http://dx.doi.org/10.1089/cbr.2016.2132 | DOI Listing |
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