Can fluorodeoxyglucose positron emission tomography/computed tomography avoid negative iliac crest biopsies in evaluation of marrow involvement by lymphoma at time of initial staging?
Can fluorodeoxyglucose positron emission tomography/computed tomography avoid negative iliac crest biopsies in evaluation of marrow involvement by lymphoma at time of initial staging?
复制标题
在初始分期评估淋巴瘤骨髓受累时，氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描能否避免髂嵴活检阴性？
DOI：
10.3109/10428194.2011.593273
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发表时间：
2011
影响因子：
2.6
通讯作者：
S. Varma
中科院分区：
文献类型：
--
作者：
B. Mittal;K. Manohar;P. Malhotra;R. Das;R. Kashyap;A. Bhattacharya;N. Varma;S. Varma
骨髓受累（BMI）的评估对淋巴瘤的准确诊断和治疗方案的选择具有重要意义。传统的双侧髂嵴活检（ILBMB）有许多局限性。F-18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）是检测BMI的有用研究工具。分析了97例非霍奇金淋巴瘤（NHL）或霍奇金淋巴瘤（HL）患者的F-18 FDG PET/CT数据。7-10天后进行ILBMB。根据FDG PET/CT和ILBMB结果得出的复合标准，对38/97例患者进行了BMI的最终诊断。ILBMB检测29/38例患者、2/5例HL患者、27/33例NHL患者、19/25例侵袭性NHL患者和8/8例惰性NHL患者的BMI，灵敏度分别为76%、40%、82%、76%和100%。5/5例HL患者和29/33例NHL患者中，FDG PET/CT对BMI呈真阳性，包括25/25例侵袭性NHL患者和4/8例惰性NHL患者，敏感性分别为100%、88%、100%和50%。FDGPET/CT对HL和侵袭性NHL的诊断敏感性优于ILBMB，但对惰性淋巴瘤的诊断敏感性较差。此外，FDG PET/CT在HL和侵袭性NHL中具有非常高的阴性预测值，接近100%，这可能有助于避免阴性ILBMB。
Abstract The assessment of bone marrow involvement (BMI) is important for accurate prognostication and deciding the appropriate therapy in patients with lymphoma. Conventional bilateral iliac crest biopsies (ILBMBs) have many limitations. F-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) is a useful investigative tool for detecting BMI. F-18 FDG PET/CT data for 97 patients with either non-Hodgkin lymphoma (NHL) or Hodgkin lymphoma (HL) were analyzed. ILBMB was performed 7–10 days later. A final diagnosis of BMI was made in 38/97 patients on the basis of composite criteria derived from both FDG PET/CT and ILBMB results. ILBMB detected BMI in 29/38 patients, 2/5 patients with HL, 27/33 patients with NHL, 19/25 patients with aggressive NHL, and 8/8 patients with indolent NHL with a sensitivity of 76%, 40%, 82%, 76%, and 100%, respectively. FDG PET/CT was true positive for BMI in 5/5 patients with HL and 29/33 patients with NHL, comprising 25/25 patients with aggressive NHL and 4/8 patients with indolent NHL, with a sensitivity of 100%, 88%, 100%, and 50%, respectively. FDG PET/CT performed better than ILBMB in cases of HL and aggressive NHL, but its sensitivity was poor in cases of indolent lymphoma. In addition, FDG PET/CT had a very high negative predictive value approaching 100% in HL and aggressive NHL, which might help in avoiding negative ILBMBs.