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Can Positron Emission Tomography and Computed Tomography Be a Substitute for Bone Marrow Biopsy in Detection of Bone Marrow Involvement in Patients with Hodgkin's or Non-Hodgkin's Lymphoma?

Çetin G, Çıkrıkçıoğlu MA, Özkan T, Karatoprak C, Ar MC, Eşkazan AE, Ayer M, Cerit A, Gözübenli K, Uysal BB, Erdem S, Ergül N, Tatar G, Çermik TF - Turk J Haematol (2015)

Bottom Line: There were discordant results in 35 patients (9 HL, 26 aNHL), 16 of them with positive BMB and negative PET/ CT results and 19 of them with negative BMB and positive PET/CT results.We observed that PET/CT is effective to detect BMI, despite it alone not being sufficient to evaluate BMI in HL and aNHL.In suspected focal involvement, combining biopsy and PET/CT might improve staging results.

View Article: PubMed Central - PubMed

ABSTRACT

Introduction: Positron emission tomography and computed tomography (PET/CT) has become an important part of staging and treatment evaluation algorithms of lymphoma. We aimed to compare the results of PET/CT with bone marrow biopsy (BMB) with respect to bone marrow involvement (BMI) in patients with Hodgkin's lymphoma (HL) and aggressive non-Hodgkin's lymphoma (aNHL).

Methods: The medical files of a total of 297 patients diagnosed with HL or aNHL and followed at the hematology clinics of 3 major hospitals in İstanbul between 2008 and 2012 were screened retrospectively and 161 patients with classical HL and aNHL were included in the study. The patients were referred for PET/CT and BMB at the initial staging. BMB was performed as the reference standard for the evaluation of BMI.

Results: There were 61 (38%) HL and 100 (62%) aNHL patients. Concordant results were revealed between PET/CT and BMB in 126 patients (78%) (52 HL, 74 aNHL), 20 with positive PET/CT and BMB results and 106 with negative PET/CT and BMB results. There were discordant results in 35 patients (9 HL, 26 aNHL), 16 of them with positive BMB and negative PET/ CT results and 19 of them with negative BMB and positive PET/CT results.

Discussion and conclusion: We observed that PET/CT is effective to detect BMI, despite it alone not being sufficient to evaluate BMI in HL and aNHL. Bone marrow trephine biopsy and PET/CT should be considered as mutually complementary methods for detection of BMI in patients with lymphoma. In suspected focal involvement, combining biopsy and PET/CT might improve staging results.

No MeSH data available.


Related in: MedlinePlus

Positron emission tomography and computed tomography images. a) Aggressive non-Hodgkin’s lymphoma patient bone marrow involvement-positive in bone marrow biopsy and bone marrow involvement-negative in positron emission tomography and computed tomography imaging, b) Aggressive non-Hodgkin’s lymphoma patient bone marrow involvement-negative in bone marrow biopsy and bone marrow involvement-positive in positron emission tomography and computed tomography imaging, c) Hodgkin’s lymphoma patient bone marrow involvement-positive in bone marrow biopsy and positron emission tomography and computed tomography imaging together, d) Hodgkin’s lymphoma patient bone marrow involvement-negative in bone marrow biopsy and positron emission tomography and computed tomography imaging together.
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f1: Positron emission tomography and computed tomography images. a) Aggressive non-Hodgkin’s lymphoma patient bone marrow involvement-positive in bone marrow biopsy and bone marrow involvement-negative in positron emission tomography and computed tomography imaging, b) Aggressive non-Hodgkin’s lymphoma patient bone marrow involvement-negative in bone marrow biopsy and bone marrow involvement-positive in positron emission tomography and computed tomography imaging, c) Hodgkin’s lymphoma patient bone marrow involvement-positive in bone marrow biopsy and positron emission tomography and computed tomography imaging together, d) Hodgkin’s lymphoma patient bone marrow involvement-negative in bone marrow biopsy and positron emission tomography and computed tomography imaging together.

Mentions: There were 61 (37.8%) and 100 (62.2%) patients with HL and aNHL, respectively. Table 1 summarizes patient characteristics, including age, sex, and stages of disease. BMI was detected in 36 patients (22.3%) by BMB and 39 patients (24.2%) by PET/CT. If BMB and PET/CT results supported each other, they were considered as concordant results. Regarding the type of lymphoma, this study showed a concordance between PET/CT and BMB in 126 patients (78%) (74 aNHL, 52 HL), of which 20 were positive (15 aNHL, 5 HL) and 106 were negative (59 aNHL, 47 HL). If BMB and PET/CT results conflicted with each other, they were considered as discordant results. Discordant results were observed in 35 cases (22%): 19 of them with positive PET/CT and negative BMB results (12 aNHL, 7 HL) and 16 with negative PET/CT and positive BMB results (14 aNHL, 2 HL). Comparison of BMB and PET/CT results in the detection of BMI are summarized in Table 2 (Figure 1).


Can Positron Emission Tomography and Computed Tomography Be a Substitute for Bone Marrow Biopsy in Detection of Bone Marrow Involvement in Patients with Hodgkin's or Non-Hodgkin's Lymphoma?

Çetin G, Çıkrıkçıoğlu MA, Özkan T, Karatoprak C, Ar MC, Eşkazan AE, Ayer M, Cerit A, Gözübenli K, Uysal BB, Erdem S, Ergül N, Tatar G, Çermik TF - Turk J Haematol (2015)

Positron emission tomography and computed tomography images. a) Aggressive non-Hodgkin’s lymphoma patient bone marrow involvement-positive in bone marrow biopsy and bone marrow involvement-negative in positron emission tomography and computed tomography imaging, b) Aggressive non-Hodgkin’s lymphoma patient bone marrow involvement-negative in bone marrow biopsy and bone marrow involvement-positive in positron emission tomography and computed tomography imaging, c) Hodgkin’s lymphoma patient bone marrow involvement-positive in bone marrow biopsy and positron emission tomography and computed tomography imaging together, d) Hodgkin’s lymphoma patient bone marrow involvement-negative in bone marrow biopsy and positron emission tomography and computed tomography imaging together.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4563196&req=5

f1: Positron emission tomography and computed tomography images. a) Aggressive non-Hodgkin’s lymphoma patient bone marrow involvement-positive in bone marrow biopsy and bone marrow involvement-negative in positron emission tomography and computed tomography imaging, b) Aggressive non-Hodgkin’s lymphoma patient bone marrow involvement-negative in bone marrow biopsy and bone marrow involvement-positive in positron emission tomography and computed tomography imaging, c) Hodgkin’s lymphoma patient bone marrow involvement-positive in bone marrow biopsy and positron emission tomography and computed tomography imaging together, d) Hodgkin’s lymphoma patient bone marrow involvement-negative in bone marrow biopsy and positron emission tomography and computed tomography imaging together.
Mentions: There were 61 (37.8%) and 100 (62.2%) patients with HL and aNHL, respectively. Table 1 summarizes patient characteristics, including age, sex, and stages of disease. BMI was detected in 36 patients (22.3%) by BMB and 39 patients (24.2%) by PET/CT. If BMB and PET/CT results supported each other, they were considered as concordant results. Regarding the type of lymphoma, this study showed a concordance between PET/CT and BMB in 126 patients (78%) (74 aNHL, 52 HL), of which 20 were positive (15 aNHL, 5 HL) and 106 were negative (59 aNHL, 47 HL). If BMB and PET/CT results conflicted with each other, they were considered as discordant results. Discordant results were observed in 35 cases (22%): 19 of them with positive PET/CT and negative BMB results (12 aNHL, 7 HL) and 16 with negative PET/CT and positive BMB results (14 aNHL, 2 HL). Comparison of BMB and PET/CT results in the detection of BMI are summarized in Table 2 (Figure 1).

Bottom Line: There were discordant results in 35 patients (9 HL, 26 aNHL), 16 of them with positive BMB and negative PET/ CT results and 19 of them with negative BMB and positive PET/CT results.We observed that PET/CT is effective to detect BMI, despite it alone not being sufficient to evaluate BMI in HL and aNHL.In suspected focal involvement, combining biopsy and PET/CT might improve staging results.

View Article: PubMed Central - PubMed

ABSTRACT

Introduction: Positron emission tomography and computed tomography (PET/CT) has become an important part of staging and treatment evaluation algorithms of lymphoma. We aimed to compare the results of PET/CT with bone marrow biopsy (BMB) with respect to bone marrow involvement (BMI) in patients with Hodgkin's lymphoma (HL) and aggressive non-Hodgkin's lymphoma (aNHL).

Methods: The medical files of a total of 297 patients diagnosed with HL or aNHL and followed at the hematology clinics of 3 major hospitals in İstanbul between 2008 and 2012 were screened retrospectively and 161 patients with classical HL and aNHL were included in the study. The patients were referred for PET/CT and BMB at the initial staging. BMB was performed as the reference standard for the evaluation of BMI.

Results: There were 61 (38%) HL and 100 (62%) aNHL patients. Concordant results were revealed between PET/CT and BMB in 126 patients (78%) (52 HL, 74 aNHL), 20 with positive PET/CT and BMB results and 106 with negative PET/CT and BMB results. There were discordant results in 35 patients (9 HL, 26 aNHL), 16 of them with positive BMB and negative PET/ CT results and 19 of them with negative BMB and positive PET/CT results.

Discussion and conclusion: We observed that PET/CT is effective to detect BMI, despite it alone not being sufficient to evaluate BMI in HL and aNHL. Bone marrow trephine biopsy and PET/CT should be considered as mutually complementary methods for detection of BMI in patients with lymphoma. In suspected focal involvement, combining biopsy and PET/CT might improve staging results.

No MeSH data available.


Related in: MedlinePlus