18F-FDG PET/CT versus bone marrow biopsy in detecting bone marrow infiltration in initial staging of pediatric lymphoma

Nahla Bashank; Seham Sharef; Taha Zaki Mohran; Maha Khalil

doi:10.1186/s41824-024-00200-0

¹⁸F-FDG PET/CT versus bone marrow biopsy in detecting bone marrow infiltration in initial staging of pediatric lymphoma

EJNMMI Rep. 2024 Apr 15;8(1):8. doi: 10.1186/s41824-024-00200-0.

Authors

Nahla Bashank¹, Seham Sharef², Taha Zaki Mohran³, Maha Khalil²

Affiliations

¹ Department of Clinical Oncology and Nuclear Medicine, Assiut University Hospital, Assiut University, Assiut, Egypt. nahla_bashank_2006@yahoo.com.
² Radiotherapy and Nuclear Medicine Unit, South Egypt Cancer Institute, Assiut University, Assiut, Egypt.
³ Department of Clinical Oncology and Nuclear Medicine, Assiut University Hospital, Assiut University, Assiut, Egypt.

Abstract

Background: To evaluate the efficacy of PET/CT using¹⁸F-FDG (¹⁸F-fluorodeoxyglucose) as a radiotracer compared to conventional bone marrow biopsy (BMB) in detecting infiltration to bone marrow (BM) in pediatric patients with lymphoma at the time of initial diagnosis.

Methods: 66 pediatric patients with lymphoma (47Hodgkin's and 19non-Hodgkin's lymphoma) were referred for initial staging by¹⁸F-FDG PET/CT study. All patients underwent bilateral iliac BMB and ¹⁸F-FDG PET/CT scan with no more than 2 weeks interval in-between. Follow-up for at least 6 months was used as a reference standard to compare diagnostic performance between two modalities in detecting bone marrow infiltration (BMI).

Results: Sensitivity, specificity, accuracy, as well as positive and negative predictive values of ¹⁸F-FDG PET/CT in detecting BMI were (80%, 86%, 85%, 63%, and 94%) in contrast to BMB (80%, 53%, 59%, 33%, and 90%) respectively. ¹⁸F-FDG PET/CT was concordant to BMB in 39/66 patients (59%).

Conclusion: ¹⁸F-FDG PET/CT was more accurate and specific, with higher predictive values than BMB in detecting BMI during initial staging of pediatric lymphoma. In most pediatric lymphoma patients, ¹⁸F-FDG PET/CT can be used instead of BMB to determine BMI during their initial staging process.

Keywords: 18F-FDG; Bone marrow biopsy; Bone marrow infiltration; Initial staging; PET/CT; Pediatric lymphoma.