Özpolat H Tahsin, Yilmaz Ebru, Goksoy Hasan Sami, Özpolat Sahre, Dogan Öner, Unal Seher Nilgun, Nalcaci Meliha
Bloodworks Research Institute, Seattle, WA, USA.
Department of Nuclear Medicine, Istanbul School of Medicine, Istanbul, Turkey.
Blood Res. 2018 Dec;53(4):281-287. doi: 10.5045/br.2018.53.4.281. Epub 2018 Dec 17.
Bone marrow involvement (BMI) affects the lymphoma stage, survival, and treatment. Bone marrow biopsy (BMB) and fluorodeoxyglucose (FDG) positron emission tomography- computed tomography (PET/CT) are useful techniques to detect BMI. Both have advantages and disadvantages. We aimed to identify factors that could be used to predict BMI with positive and negative results on PET/CT compare them with BMB in newly diagnosed patients with lymphoma.
We included 22 non-Hodgkin and 16 Hodgkin lymphoma patients in this single center study. All patients had PET/CT examination and BMB before treatment. BMI in BMB was reported as negative or positive. Bone marrow was classified into 3 types by FDG uptake on PT/CT; diffuse involvement, focal involvement, and normal bone marrow.
PET/CT and BMB results were concordant (7 positive, 15 negative) in 22 patients (57%). We evaluated concordant and discordant patient characteristics and risk-stratified patients for BMI. Our findings suggest that patients with diffuse FDG uptake on PET/CT, especially patients with advanced age and low platelet and white blood cell counts, are likely to have BMI and could potentially forego BMB. Patients with negative PET/CT findings and no significant laboratory abnormalities are very unlikely to have BMI.
Our results suggest that BMI should not be decided solely based PET/CT or BMB findings. It is reasonable to use both diagnostic assays along with clinical and laboratory findings. PET/CT result, clinical and laboratory findings could be useful for predicting BMI in patient for whom BMB is contraindicated.
骨髓受累（BMI）会影响淋巴瘤的分期、生存及治疗。骨髓活检（BMB）和氟脱氧葡萄糖（FDG）正电子发射断层扫描-计算机断层扫描（PET/CT）是检测BMI的有用技术。两者都有优缺点。我们旨在确定可用于预测PET/CT结果为阳性和阴性的BMI的因素，并将其与新诊断的淋巴瘤患者的BMB结果进行比较。
在这项单中心研究中，我们纳入了22例非霍奇金淋巴瘤患者和16例霍奇金淋巴瘤患者。所有患者在治疗前均接受了PET/CT检查和BMB。BMB中的BMI报告为阴性或阳性。根据PET/CT上FDG摄取情况，将骨髓分为3种类型：弥漫性受累、局灶性受累和正常骨髓。
22例患者（57%）的PET/CT和BMB结果一致（7例阳性，15例阴性）。我们评估了BMI结果一致和不一致的患者特征，并对患者进行了风险分层。我们的研究结果表明，PET/CT上FDG摄取弥漫的患者，尤其是年龄较大、血小板和白细胞计数较低的患者，可能存在BMI，可能无需进行BMB。PET/CT结果为阴性且无明显实验室异常的患者极不可能存在BMI。
我们的结果表明，BMI不应仅根据PET/CT或BMB结果来确定。将这两种诊断方法与临床和实验室检查结果结合使用是合理的。PET/CT结果、临床和实验室检查结果对于预测禁忌进行BMB的患者的BMI可能有用。
