Aguado-Vázquez Tania M, Olivas-Martínez Antonio, Cancino-Ramos Uvi, Zúñiga-Tamayo Diego A, Lome-Maldonado María Del C A, Rivas-Vera Silvia, García-Pérez Francisco O, Candelaria-Hernández Myrna G
Department of Hematology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
Division of Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
Rev Invest Clin. 2020 May 7;73(2):79-86. doi: 10.24875/RIC.20000239.
Bone marrow evaluation (BME) is crucial for establishing an accurate staging and prognosis in lymphoma patients.
The objective of the study was to study the diagnostic performance of 18F-fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET-CT) against bone marrow biopsy (BMB) for BME.
Five hundred patient files of newly diagnosed lymphoma patients treated at an academic medical center were reviewed for BME at diagnosis by BMB and FDG PET-CT. Diagnostic performance of FDG PET-CT for detecting bone marrow infiltration (BMI)was assessed, as well as clinical predictors for positive BMB and positive FDG PET-CT.
BMB was positive in 16.3% of all patients, and 28.7% had a positive FDG PET-CT for BMI. Overall, the sensitivity of FDG PET-CT was 74.1% and specificity 80.1%. As for predictors for BMB and FDG PET-CT positivity, B symptoms and thrombocytopenia were independent factors for BMI. Seventy-four patients had discordant results between BMB and FDG PET-CT, non-Hodgkin lymphoma (NHL) having the most significant discordance. This discrepancy did not affect treatment.
FDG PET-CT shows excellent performance for the detection of BMI in Hodgkin lymphoma. For diffuse large B-cell lymphoma, we recommend performing BMB and FDG PET-CT as complementary tests. In all other NHL, a unilateral BMB is mandatory at diagnosis.
骨髓评估（BME）对于淋巴瘤患者准确分期及预后判断至关重要。
本研究旨在探讨18F-氟脱氧葡萄糖正电子发射断层扫描-计算机断层扫描（FDG PET-CT）相对于骨髓活检（BMB）用于骨髓评估的诊断效能。
回顾了在一家学术医疗中心接受治疗的500例新诊断淋巴瘤患者的病历，这些患者在诊断时接受了BMB和FDG PET-CT进行骨髓评估。评估了FDG PET-CT检测骨髓浸润（BMI）的诊断效能，以及BMB阳性和FDG PET-CT阳性的临床预测因素。
所有患者中16.3%的BMB结果为阳性，28.7%的患者FDG PET-CT检测BMI呈阳性。总体而言，FDG PET-CT的敏感性为74.1%，特异性为80.1%。至于BMB和FDG PET-CT阳性的预测因素，B症状和血小板减少是BMI的独立因素。74例患者BMB和FDG PET-CT结果不一致，非霍奇金淋巴瘤（NHL）的不一致最为显著。这种差异不影响治疗。
FDG PET-CT在检测霍奇金淋巴瘤的BMI方面表现出色。对于弥漫性大B细胞淋巴瘤，我们建议同时进行BMB和FDG PET-CT作为补充检查。在所有其他NHL中，诊断时必须进行单侧BMB。
