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  • Title: Biopsy versus FDG PET/CT in the initial evaluation of bone marrow involvement in pediatric lymphoma patients.
    Author: Cheng G, Chen W, Chamroonrat W, Torigian DA, Zhuang H, Alavi A.
    Journal: Eur J Nucl Med Mol Imaging; 2011 Aug; 38(8):1469-76. PubMed ID: 21505896.
    Abstract:
    PURPOSE: The objective is to assess the role of (18)F-2-fluoro-2-deoxy-D: -glucose (FDG) positron emission tomography (PET)/CT versus bone marrow biopsy (BMB) in the initial evaluation of bone marrow (BM) involvement in pediatric lymphoma patients. METHODS: Fifty-four pediatric patients with pathologically proven lymphoma [31 Hodgkin's disease (HD), 23 non-Hodgkin's lymphoma (NHL)] were included in this study. All patients had soft tissue biopsy and BMB and had FDG PET/CT scans within 2 weeks of biopsy. RESULTS: Among the 31 HD patients, FDG PET/CT revealed positive BM involvement in 4 patients, while BMB revealed BM involvement in 2 patients who were also positive on FDG PET/CT imaging. Among the 23 NHL patients, FDG PET/CT revealed positive BM involvement in 8 patients, while biopsy revealed BM involvement in 5 patients on initial studies (4 of them were also positive on FDG PET/CT, and 1 was BMB positive but was negative on FDG PET/CT), plus 1 false-negative BMB study initially but positive on repeat biopsy after FDG PET/CT. The overall sensitivity of detecting BM involvement by lymphoma was 92 and 54% (p < 0.05) for FDG PET/CT and BMB, respectively. It is noted that there were more positive BMB findings in patients with abnormal FDG activities seen in the biopsy sites on PET/CT. CONCLUSION: Our study demonstrates that FDG PET/CT has high sensitivity and accuracy and a substantial complementary value to BMB in the initial diagnosis of pediatric lymphoma, and should be employed as a first-line study.
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