The Predictive Value of FDG PET/CT in the Evaluation of Bone Marrow Involvement in Lymphoma Patients

Introduction: The aim of the current study was to determine the role of PET-CT in the evaluation of bone marrow (BM) involvement during initial staging in patients with newly diagnosed lymphoma. Methods: A retrospective analysis was made of 104 patients who were admitted to our Hematology Department between January 2010 and September 2016 and were diagnosed with lymphoma. Patients were classified as Hodgkin (HL) and Non-Hodgkin Lyphoma (NHL). NHL patients were evaluated in two subgroups as aggressive and indolent. Results: The patients comprised 54 (51.9%) males and 50 (48.1%) females and were classified as 24 patients with HL and 80 with NHL. BM biopsy showed BM involvement in 40 patients (38.5%) and there was no pathological finding in 64 (61.5%) patients. BM involvement was detected on PET-CT in 41 (39.4%) of the whole patient group, of which 26 (63.4%) cases had diffuse infiltration and the remaining 15 (36.6%) cases had patchy infiltration. For all lymphoma patients, sensitivity of PET-CT was 80% and specificity was 85.9%. Sensitivity and specificity of PET-CT was 92.3% and 81.8% for HL patients and 74.1% and 86.8% for NHL patients, respectively. For only aggressive NHL patients, PET-CT sensitivity was 81.8% and specificity was 87.75%. Discussion and Conclusion: PET-CT is an effective method for assessing BM involvement with a higher sensitivity especially for HL and aggressive NHL patients in detecting patchy involvement. The fact that it is non-invasive and easy to apply may support that it can be used instead of BM biopsy.