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Role of FDG-PET/CT in detecting lymphomatous bone marrow involvement in patients with newly diagnosed diffuse large B-cell lymphoma

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Abstract

To evaluate the role of FDG-PET/CT in detecting bone marrow (BM) involvement, pre-treatment bilateral bone marrow biopsies (BMBs) and FDG-PET/CT scans of 89 patients with diffuse large B-cell lymphoma (DLBCL) treated with rituximab–CHOP were reviewed and analyzed. Fourteen patients (15.7%) had lymphomatous involvement based on BMB (BMB+), and 17 patients (19.1%) had the possibility of BM involvement on FDG-PET/CT (FDG-PET/CT+). Seventy-two patients (80.8%) had concordant results between BMB and FDG-PET/CT (seven patients were positive for both, and 65 patients were negative for both), but 17 patients (19.2%) had a discordant interpretation (seven patients were BMB+ and FDG-PET/CT−, and ten were BMB− and FDG-PET/CT+). Although BMB+ patients had an inferior 2-year EFS (37.0% vs. 79.8%, p < 0.001) and OS (36.3% vs. 81.0%, p < 0.001) compared to BMB− patients, no differences in EFS (62.6% vs. 72.7%, p = 0.185) and OS (59.4% vs. 78.0%, p = 0.146) were shown between FDG-PET/CT+ and FDG-PET/CT− patients. Whereas six of seven patients with diffuse hypermetabolism were BMB+, only one of ten patients with focal hypermetabolism was BMB+. The results suggest that FDG-PET/CT had a limited value to detect BM involvement in patients with DLBCL. Focal hypermetabolism of hematopoietic BM in FDG-PET/CT had no impact on survival.

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Acknowledgements

The authors wish to thank Hyung Sun Kim, RN, Soo Jung Lee, RN and Hee Keun Kang, RN for their support in the clinical care of the analyzed patients.

Conflicts of interest

The authors have no conflicts of interest to declare.

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Authors and Affiliations

  1. Department of Internal Medicine, Gachon University Gil Hospital, Gachon University of Medicine and Science School of Medicine, Incheon, Republic of Korea

    Junshik Hong, Yeonjeong Park, Jinny Park & Jae Hoon Lee

  2. Department of Nuclear Medicine, Gachon University Gil Hospital, Gachon University of Medicine and Science School of Medicine, Incheon, Republic of Korea

    Yukyung Lee, Seog Gyun Kim & Kyung Hoon Hwang

  3. Department of Laboratory Medicine, Gachon University Gil Hospital, Gachon University of Medicine and Science School of Medicine, Incheon, Republic of Korea

    Soon Ho Park, Jihoon Jeong, Kyung-Hee Kim & Jeong Yeal Ahn

  4. Department of Pathology, Gachon University Gil Hospital, Gachon University of Medicine and Science School of Medicine, Incheon, Republic of Korea

    Sanghui Park

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  1. Junshik Hong
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Correspondence to Jae Hoon Lee.

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Hong, J., Lee, Y., Park, Y. et al. Role of FDG-PET/CT in detecting lymphomatous bone marrow involvement in patients with newly diagnosed diffuse large B-cell lymphoma. Ann Hematol 91, 687–695 (2012). https://doi.org/10.1007/s00277-011-1353-6

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  • DOI: https://doi.org/10.1007/s00277-011-1353-6

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