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European Radiology
Published in: European Radiology 7/2018

01-07-2018 | Paediatric

PET/CT predicts bone marrow involvement in paediatric non-Hodgkin lymphoma and may preclude the need for bone marrow biopsy in selected patients

Authors: Suyun Chen, Shaoyan Wang, Kejun He, Chao Ma, Hongliang Fu, Hui Wang

Published in: European Radiology | Issue 7/2018

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Abstract

Objectives

To investigate the role of 18F-FDG PET/CT to detect bone marrow (BM) involvement in paediatric non-Hodgkin lymphoma (NHL).

Methods

Pretreatment PET/CT scans from 93 consecutive paediatric patients with NHL were retrospectively reviewed. Patterns of BM FDG uptake and standardized uptake value of the fifth lumbar vertebra (SUVBM) were compared with bone marrow biopsy (BMB) for diagnosis of BM involvement.

Results

Of 93 patients, 41 were judged to have BM involvement. Thirty-nine were identified by PET/CT, versus 23 by BMB. Sensitivity and specificity were 95 % and 98 % for PET/CT and 56 % and 100 % for BMB, respectively. None of the patients with BM FDG uptake lower than liver had positive BMB. In 45 patients presenting homogeneously increased BM uptake, positive BMB was achieved in 93 % (14/15) of patients with FDG uptake expanding to the distal portion of extremities, compared to 7 % (2/30) of those without. A multifocal pattern was observed in 25 patients and 18 had negative BMB. SUVBM differentiated BM involvement from benign BM activation with an area under the curve of 0.885 (p < 0.001).

Conclusions

PET/CT had a high level of accuracy for detecting BM involvement in paediatric NHL. BMB might be omitted in selected patients.

Key Points

• PET/CT allows for accurate detection of bone marrow involvement.
• Patterns of bone marrow FDG uptake are highly correlated with marrow disease.
• Bone marrow biopsy could be omitted in selected paediatric patients.
Literature
1.
Minard-Colin V, Brugieres L, Reiter A et al (2015) Non-Hodgkin lymphoma in children and adolescents: progress through effective collaboration, current knowledge, and challenges ahead. J Clin Oncol 33:2963–2974CrossRefPubMedPubMedCentral
2.
Carr R, Barrington SF, Madan B et al (1998) Detection of lymphoma in bone marrow by whole-body positron emission tomography. Blood 91:3340–3346PubMed
3.
Cheson BD, Fisher RI, Barrington SF et al (2014) Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol 32:3059–3068CrossRefPubMedPubMedCentral
4.
Khan AB, Barrington SF, Mikhaeel NG et al (2013) PET-CT staging of DLBCL accurately identifies and provides new insight into the clinical significance of bone marrow involvement. Blood 122:61–67CrossRefPubMed
5.
Purz S, Mauz-Korholz C, Korholz D et al (2011) [18F]Fluorodeoxyglucose positron emission tomography for detection of bone marrow involvement in children and adolescents with Hodgkin's lymphoma. J Clin Oncol 29:3523–3528CrossRefPubMed
6.
Berthet L, Cochet A, Kanoun S et al (2013) In newly diagnosed diffuse large B-cell lymphoma, determination of bone marrow involvement with 18F-FDG PET/CT provides better diagnostic performance and prognostic stratification than does biopsy. J Nucl Med 54:1244–1250CrossRefPubMed
7.
Ujjani CS, Hill EM, Wang H et al (2016) (18) F-FDG PET-CT and trephine biopsy assessment of bone marrow involvement in lymphoma. Br J Haematol 174:410–416CrossRefPubMed
8.
Chen-Liang TH, Martin-Santos T, Jerez A et al (2015) 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. Am J Hematol 90:686–690CrossRefPubMed
9.
Perry C, Lerman H, Joffe E et al (2016) The Value of PET/CT in Detecting Bone Marrow Involvement in Patients With Follicular Lymphoma. Medicine (Baltimore) 95:e2910CrossRef
10.
11.
El-Galaly TC, d'Amore F, Mylam KJ et al (2012) Routine bone marrow biopsy has little or no therapeutic consequence for positron emission tomography/computed tomography-staged treatment-naive patients with Hodgkin lymphoma. J Clin Oncol 30:4508–4514CrossRefPubMed
12.
Shankar A, Fiumara F, Pinkerton R (2008) Role of FDG PET in the management of childhood lymphomas--case proven or is the jury still out? Eur J Cancer 44:663–673CrossRefPubMed
13.
Ducassou S, Ferlay C, Bergeron C et al (2011) Clinical presentation, evolution, and prognosis of precursor B-cell lymphoblastic lymphoma in trials LMT96, EORTC 58881, and EORTC 58951. Br J Haematol 152:441–451CrossRefPubMed
14.
Mussolin L, Pillon M, d'Amore ES et al (2011) Minimal disseminated disease in high-risk Burkitt's lymphoma identifies patients with different prognosis. J Clin Oncol 29:1779–1784CrossRefPubMed
15.
Cheng G, Chen W, Chamroonrat W, Torigian DA, Zhuang H, Alavi A (2011) Biopsy versus FDG PET/CT in the initial evaluation of bone marrow involvement in pediatric lymphoma patients. Eur J Nucl Med Mol Imaging 38:1469–1476CrossRefPubMed
16.
Agool A, Glaudemans AW, Boersma HH, Dierckx RA, Vellenga E, Slart RH (2011) Radionuclide imaging of bone marrow disorders. Eur J Nucl Med Mol Imaging 38:166–178CrossRefPubMed
17.
Agrawal K, Mittal BR, Bansal D et al (2013) Role of F-18 FDG PET/CT in assessing bone marrow involvement in pediatric Hodgkin's lymphoma. Ann Nucl Med 27:146–151CrossRefPubMed
18.
Pakos EE, Fotopoulos AD, Ioannidis JP (2005) 18F-FDG PET for evaluation of bone marrow infiltration in staging of lymphoma: a meta-analysis. J Nucl Med 46:958–963PubMed
19.
Cerci JJ, Gyorke T, Fanti S et al (2014) Combined PET and biopsy evidence of marrow involvement improves prognostic prediction in diffuse large B-cell lymphoma. J Nucl Med 55:1591–1597CrossRefPubMed
20.
Adams HJ, Kwee TC, Fijnheer R, Dubois SV, Nievelstein RA, de Klerk JM (2014) Bone marrow 18F-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography cannot replace bone marrow biopsy in diffuse large B-cell lymphoma. Am J Hematol 89:726–731CrossRefPubMed
21.
Waitches G, Zawin JK, Poznanski AK (1994) Sequence and rate of bone marrow conversion in the femora of children as seen on MR imaging: are accepted standards accurate? AJR Am J Roentgenol 162:1399–1406CrossRefPubMed
22.
Zawin JK, Jaramillo D (1993) Conversion of bone marrow in the humerus, sternum, and clavicle: changes with age on MR images. Radiology 188:159–164CrossRefPubMed
23.
Moog F, Bangerter M, Kotzerke J, Guhlmann A, Frickhofen N, Reske SN (1998) 18-F-fluorodeoxyglucose-positron emission tomography as a new approach to detect lymphomatous bone marrow. J Clin Oncol 16:603–609CrossRefPubMed
24.
Weiler-Sagie M, Bushelev O, Epelbaum R et al (2010) (18)F-FDG avidity in lymphoma readdressed: a study of 766 patients. J Nucl Med 51:25–30CrossRefPubMed
25.
Park JH, Pahk K, Kim S et al (2016) Fluorine-18 fluorodeoxyglucose positron emission tomography imaging of T-lymphoblastic lymphoma patients. Oncol Lett 12:1620–1622CrossRefPubMedPubMedCentral
26.
Zeng W, Lechowicz MJ, Winton E, Cho SM, Galt JR, Halkar R (2009) Spectrum of FDG PET/CT findings in Burkitt lymphoma. Clin Nucl Med 34:355–358CrossRefPubMed
27.
28.
Fan C, Hernandez-Pampaloni M, Houseni M et al (2007) Age-related changes in the metabolic activity and distribution of the red marrow as demonstrated by 2-deoxy-2-[F-18]fluoro-D-glucose-positron emission tomography. Mol Imaging Biol 9:300–307CrossRefPubMed
Metadata
Title
PET/CT predicts bone marrow involvement in paediatric non-Hodgkin lymphoma and may preclude the need for bone marrow biopsy in selected patients
Authors
Suyun Chen
Shaoyan Wang
Kejun He
Chao Ma
Hongliang Fu
Hui Wang
Publication date
01-07-2018
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 7/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-018-5306-5

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