Derlin Thorsten, Alchalby Haefaa, Bannas Peter, Veldhoen Simon, Apostolova Ivayla, Triviai Ioanna, Bengel Frank M, Kröger Nicolaus
Department of Nuclear Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany,
Eur J Nucl Med Mol Imaging. 2015 Apr;42(5):696-705. doi: 10.1007/s00259-014-2983-4. Epub 2015 Jan 20.
Myelofibrosis is a haematopoietic stem cell neoplasm characterized by bone marrow inflammation, reactive marrow fibrosis and extramedullary haematopoiesis. The aim of this study was to determine if (18)F-FDG PET/CT can be used to noninvasively visualize and quantify the extent and activity of bone marrow involvement.
In 30 patients, the biodistribution of (18)F-FDG was analysed by measuring the standardized uptake value in the bone marrow compartment and spleen. Imaging findings were compared with laboratory, cytogenetic and histopathological data.
Retention of (18)F-FDG was observed in bone marrow and spleen. Bone marrow involvement varied, ranging from mildly increased uptake in the central skeleton to extensive uptake in most parts of the skeleton. The extent of bone marrow involvement decreased over time from initial diagnosis (r s = -0.43, p = 0.019). Metabolic activity of the bone marrow decreased as the histopathological grade of fibrosis increased (r s = -0.37, p = 0.04). There was a significant positive correlation between the metabolic activity of the bone marrow and that of the spleen (p = 0.04).
(18)F-FDG PET/CT is as a promising technique for the quantitation of bone marrow inflammation in myelofibrosis. Our data indicate that the intensity of bone marrow (18)F-FDG uptake decreases as bone marrow fibrosis increases. Further evaluation in prospective studies is required to determine the potential clinical impact and prognostic significance of PET.
骨髓纤维化是一种造血干细胞肿瘤，其特征为骨髓炎症、反应性骨髓纤维化和髓外造血。本研究的目的是确定¹⁸F-FDG PET/CT是否可用于无创可视化和量化骨髓受累的范围及活性。
对30例患者，通过测量骨髓腔和脾脏的标准化摄取值来分析¹⁸F-FDG的生物分布。将影像学结果与实验室、细胞遗传学和组织病理学数据进行比较。
观察到¹⁸F-FDG在骨髓和脾脏中潴留。骨髓受累情况各异，从中央骨骼摄取轻度增加到大部分骨骼广泛摄取。从初始诊断开始，骨髓受累范围随时间减少（rs = -0.43，p = 0.019）。随着纤维化组织病理学分级增加，骨髓代谢活性降低（rs = -0.37，p = 0.04）。骨髓代谢活性与脾脏代谢活性之间存在显著正相关（p = 0.04）。
¹⁸F-FDG PET/CT是一种用于量化骨髓纤维化中骨髓炎症的有前景的技术。我们的数据表明，随着骨髓纤维化增加，骨髓¹⁸F-FDG摄取强度降低。需要在前瞻性研究中进行进一步评估，以确定PET的潜在临床影响和预后意义。
