1. 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
- Author
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Marta Romera, Taida Martín-Santos, José María Raya, Francisco José Ortuño, Maria del Puig Cozar, Jose Contreras, José Luis Navarro, Carolina Villegas, Jose Javier Sanchez-Blanco, Hermogenes Fernandez-Muñoz, Raquel Sánchez-Vañó, Leonor Senent, Laura Frutos, Begoña Muiña, Juan Carlos Herrera, Andres Jerez, Maria Teresa Orero, Tzu-Hua Chen-Liang, Jon Uña, Aima Lancharro, Marta Fernández-González, Elena Pérez-Ceballos, Carolina Igua, and Maria Jose Remigia
- Subjects
medicine.medical_specialty ,medicine.diagnostic_test ,Bone marrow infiltration ,business.industry ,Hematology ,medicine.disease ,Lymphoma ,medicine.anatomical_structure ,immune system diseases ,Positron emission tomography ,hemic and lymphatic diseases ,Biopsy ,medicine ,Hodgkin lymphoma ,Bone marrow ,Radiology ,Stage (cooking) ,Nuclear medicine ,business ,B-cell lymphoma - Abstract
Bone marrow infiltration (BMI), categorized as an extra-nodal site, affects stage and is associated with poor prognosis in newly diagnosed lymphoma patients. We have evaluated the accuracy of PET/CT and bone marrow biopsy (BMB) to assess BMI in 372 lymphoma patients [140 Hodgkin Lymphoma (HL) and 232 High Grade B-cell non-Hodgkin Lymphoma (HG B-NHL), among them 155 Diffuse Large B-Cell Lymphoma (DLCL)]. For HL cases, and taking into account PET/CT, sensitivity, negative predictive value (NPV) and accuracy were 96.7, 99.3, and 99.3% while those of BMB were 32.3, 83.8, and 85%, respectively. For HG B-NHL and considering PET/CT, sensitivity, NPV, and accuracy were 52.7, 81.7, and 84.1%, while those of BMB were 77.6, 90.2, and 90.7%, respectively. In the HG B-NHL group, 25 patients would have been under-staged without BMB. These results lead us to recommend PET/CT and the avoidance of BMB to assess BMI in HL. In the case of HG B-NHL, bone marrow status should be assessed firstly by means of PET/CT; only in either focal or diffuse PET/CT with low borderline SUV max values or in negative cases, should BMB be carried out afterwards. In the HG B-NHL setting and at the present moment, both techniques are complementary.
- Published
- 2015