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Multicenter Study
. 2015 Sep;32(3):213-9.
doi: 10.4274/tjh.2013.0336.

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?

Güven Çetin, M Ali Çıkrıkçıoğlu, Tuba Özkan, Cumali Karatoprak, M Cem Ar, Ahmet Emre Eşkazan, Mesut Ayer, Abdullah Cerit, Kübra Gözübenli, Betül Börkü Uysal, Simge Erdem, Nurhan Ergül, Gamze Tatar, T Fikret Çermik
Multicenter Study

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?

Güven Çetin et al. Turk J Haematol. 2015 Sep.

Abstract
in English, Turkish

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.

Amaç: Positron emisyon tomografi ve bilgisayarlı tomografi (PET/CT) lenfomanın tedavi ve evreleme algoritmasının önemli bir parçası oldu. Biz çalışmamız da agresiv seyirli non Hodgkin lenfoma (aNHL) ve Hodgkin lenfomalı (HL) hastalarda kemik iliği tutulumunu göstermede kemik iliği biyopsisi (BMB) ile PET/CT sonuçlarını karşılaştırmayı amaçladık. Gereç ve Yöntemler: Çalışmaya 2008-2012 yılları arasında İstanbul’daki 3 büyük hastanede HL ve aNHL tanısı konulan 297 hasta belirlendi. Bu hastaların dosyası retrospektif olarak tarandı ve çalışma kriterlerine uygun 161 hasta çalışmaya alındı. Hastaların başlangıç evrelemesi için PET/CT ve BMB yapıldı. Kemik iliği biyopsisi, kemik iliği tutulumunu değerlendirmede standart referans olarak kabul edildi. Bulgular: Hastaların 61’inde (38%) HL ve 100’ünde (62%) aNHL vardı. Değerlendirilen 126 hastada (78%) (52 HL, 74 aNHL) PET/CT ve BMB arasında uyumlu sonuçlar olduğu görüldü. Bu hastalardan 20’sinde kemik iliği tutulumu bakımından PET/CT ve BMB sonuçları pozitif ve 106 hastanın PET/CT ve BMB negatif bulundu. Diğer taraftan 35 hastada (9 HL, 26 aNHL) uyumsuzluk vardı. Bu hastaların da 16’sında BMB pozitif iken PET/CT sonuçları negatif bulundu. Geri kalan 19 hastada BMB negatif ve PET/CT sonuçları pozitif saptandı. Sonuç: Biz aNHL ve HL hastalarını değerlendirmede tek başına yeterli olmamasına rağmen, PET/CT nin kemik iliği infiltrasyonunu belirlemede etkili olduğunu gözlemledik. Lenfomalı hastalarda kemik iliği infiltrasyonunu belirlemede; BMB ve PET/CT birbirinin tamamlayıcısı olarak düşünülmelidir. Fokal tutulumdan şüphelenildiğinde, BMB ve PET/CT’nin birlikte yapılması hastalığın evrelemesinde daha doğru sonuçlar verebilir.

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Conflict of interest statement

Conflict of Interest Statement

The authors of this paper have no conflicts of interest, including specific financial interests, relationships, and/or affiliations relevant to the subject matter or materials included.

Figures

Figure 1
Figure 1. 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.
See this image and copyright information in PMC

References

    1. Moulin-Romsee G, Hindié E, Cuenca X, Brice P, Decaudin D, Bénamor M, Brière J, Anitei M, Filmont JE, Sibon D, Kerviler E, de, Moretti JL. 18F-FDG PET/CT bone/bone marrow findings in Hodgkin’s lymphoma may circumvent the use of bone marrow trephine biopsy at diagnosis staging. Eur J Nucl Med Mol Imaging. 2010;37:1095–1105. - PubMed
    1. Devesa SS, Fears T. Non-Hodgkin’s lymphoma time trends: United States and international data. Cancer Res. 1992;52(Suppl 19):5432s–5440s. - PubMed
    1. Lister TA, Crowther D, Sutcliffe SB, Glatstein E, Canellos GP, Young RC, Rosenberg SA, Coltman CA, Tubiana M. Report of a committee convened to discuss the evaluation and staging of patients with Hodgkin’s disease: Cotswolds meeting. J Clin Oncol. 1989;7:1630–1636. - PubMed
    1. Howell SJ, Grey M, Chang J, Morgenstern GR, Cowan RA, Deakin DP, Radford JA. The value of bone marrow examination in the staging of Hodgkin’s lymphoma: a review of 955 cases seen in a regional cancer centre. Br J Haematol. 2002;119:408–411. - PubMed
    1. Pelosi E, Penna D, Deandreis D, Chiappella A, Skanjeti A, Vitolo U, Bisi G. FDG-PET in the detection of bone marrow disease in Hodgkin’s disease and aggressive non-Hodgkin’s lymphoma and its impact on clinical management. Q J Nucl Med Mol Imaging. 2008;52:9–16. - PubMed

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