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Annals of Nuclear Medicine
Published in: Annals of Nuclear Medicine 2/2015

01-02-2015 | Original Article

Bone marrow FDG-PET/CT in Hodgkin lymphoma revisited: do imaging and pathology match?

Authors: Hugo J. A. Adams, Thomas C. Kwee, Rob Fijnheer, Steven V. Dubois, Rutger A. J. Nievelstein, John M. H. de Klerk

Published in: Annals of Nuclear Medicine | Issue 2/2015

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Abstract

Purpose

To directly compare visual and quantitative 18F-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (FDG-PET/CT) to bone marrow biopsy (BMB) findings in the right posterior iliac crest in patients with newly diagnosed Hodgkin lymphoma.

Materials and methods

This retrospective study included 26 patients with newly diagnosed Hodgkin lymphoma in whom FDG-PET/CT was performed before BMB of the right posterior iliac crest. The right posterior iliac crest was assessed for bone marrow involvement, both visually and semi-quantitatively [using maximum standardized uptake value (SUVmax) measurements]. BMB of right the posterior iliac crest was used as reference standard.

Results

BMB of the right posterior iliac crest was positive in 5 (19.2 %) of 26 patients. There was full agreement between visual FDG-PET/CT and BMB findings in the right posterior iliac crest (i.e. no false-positive or false-negative FDG-PET/CT findings). Accordingly, sensitivity, specificity, positive predictive value, and negative predictive value of visual FDG-PET/CT assessment for the detection of bone marrow involvement in the right posterior iliac crest were 100 % (5/5) (95 % CI 51.1–100 %), 100 % (21/21) (95 % CI 81.8–100 %), 100 % (5/5) (95 % CI 51.1–100 %), and 100 % (21/21) (95 % CI 81.8–100 %), respectively. SUVmax of BMB-positive cases (mean ± SD: 3.4 ± 0.85) was nearly significantly higher (P = 0.052) than that of BMB-negative cases (mean ± SD 2.7 ± 0.63).

Conclusion

This histopathological correlation study confirms the very high diagnostic value of FDG-PET/CT in the detection of bone marrow involvement in newly diagnosed Hodgkin lymphoma, and supports the substitution of BMB with FDG-PET/CT in this setting.
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Metadata
Title
Bone marrow FDG-PET/CT in Hodgkin lymphoma revisited: do imaging and pathology match?
Authors
Hugo J. A. Adams
Thomas C. Kwee
Rob Fijnheer
Steven V. Dubois
Rutger A. J. Nievelstein
John M. H. de Klerk
Publication date
01-02-2015
Publisher
Springer Japan
Published in
Annals of Nuclear Medicine / Issue 2/2015
Print ISSN: 0914-7187
Electronic ISSN: 1864-6433
DOI
https://doi.org/10.1007/s12149-014-0920-z

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