Fuster David, Chiang Stephen, Andreadis Charalambos, Guan Liang, Zhuang Hongming, Schuster Stephen, Alavi Abass
Nuclear Medicine Division/Radiology Department, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Nucl Med Commun. 2006 Jan;27(1):11-5. doi: 10.1097/01.mnm.0000185000.81203.49.
To assess the usefulness of [18F]fluorodeoxyglucose positron emission tomography in the detection of bone marrow involvement in malignant lymphoma, and its impact in clinical management.
One hundred and six consecutive patients with a confirmed diagnosis of lymphoma, referred for staging or restaging of Hodgkin's lymphoma (n=18) or non-Hodgkin's lymphoma (n=88), were reviewed retrospectively. A positron emission tomography scan and bone marrow biopsy of the iliac crest were performed in all patients. The assessment of bone marrow involvement by lymphoma was confirmed by histology and/or progression of bone marrow lesions in clinical follow-up.
In 28 of 106 patients, bone marrow involvement was found. Positron emission tomography was more sensitive (86%) than bone marrow biopsy (57%). Positron emission tomography and bone marrow biopsy were concordant by positive correlation in 12 of 28 cases (43%) and by negative correlation in 77 of 78 cases (99%). Ten cases of non-Hodgkin's lymphoma and two cases of Hodgkin's lymphoma with positive positron emission tomography results and an initial negative bone marrow biopsy showed clinical progression of the bone marrow lesions and/or subsequent positive histology. These were considered as false-negative results for bone marrow biopsy. In seven of the 12 positive cases with negative bone marrow biopsy, positron emission tomography uptake distant from the site of the biopsy was seen. In four cases of follicular lymphoma, the bone marrow biopsy was positive and the positron emission tomography scan was normal.
Positron emission tomography and bone marrow biopsy are complementary in assessing the presence of bone marrow involvement in patients with malignant lymphoma. In our series, positron emission tomography was more sensitive than bone marrow biopsy in Hodgkin's and non-Hodgkin's lymphoma, except in follicular lymphoma.
评估[18F]氟脱氧葡萄糖正电子发射断层扫描在检测恶性淋巴瘤骨髓受累情况中的作用及其对临床管理的影响。
回顾性分析106例确诊淋巴瘤患者，这些患者因霍奇金淋巴瘤（n = 18）或非霍奇金淋巴瘤（n = 88）的分期或再分期而前来就诊。所有患者均进行了正电子发射断层扫描及髂嵴骨髓活检。通过组织学检查和/或临床随访中骨髓病变的进展来确认淋巴瘤骨髓受累情况。
106例患者中有28例发现骨髓受累。正电子发射断层扫描比骨髓活检更敏感（86%对57%）。在28例病例中的12例（43%），正电子发射断层扫描和骨髓活检呈正相关一致；在78例病例中的77例（99%）呈负相关一致。10例非霍奇金淋巴瘤和2例霍奇金淋巴瘤患者正电子发射断层扫描结果为阳性，初始骨髓活检为阴性，但随后出现骨髓病变的临床进展和/或组织学检查结果为阳性。这些被视为骨髓活检的假阴性结果。在12例骨髓活检为阴性的阳性病例中，有7例在远离活检部位处可见正电子发射断层扫描摄取。在4例滤泡性淋巴瘤中，骨髓活检为阳性，而正电子发射断层扫描正常。
在评估恶性淋巴瘤患者骨髓受累情况时，正电子发射断层扫描和骨髓活检具有互补性。在我们的系列研究中，除滤泡性淋巴瘤外，正电子发射断层扫描在霍奇金淋巴瘤和非霍奇金淋巴瘤中比骨髓活检更敏感。
