18F-FDG PET/CT bone/bone marrow findings in Hodgkin's lymphoma may circumvent the use of bone marrow trephine biopsy at diagnosis staging
18F-FDG PET/CT bone/bone marrow findings in Hodgkin's lymphoma may circumvent the use of bone marrow trephine biopsy at diagnosis staging
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DOI：
10.1007/s00259-009-1377-5
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发表时间：
2010-06-01
影响因子：
9.1
通讯作者：
Moretti, Jean-Luc
中科院分区：
文献类型：
--
作者：
Moulin-Romsee, Gerard;Hindie, Elif;Moretti, Jean-Luc
霍奇金淋巴瘤（HL）的准确分期是选择适当治疗的必要条件。骨髓环钻活检（BMB）是描述骨髓受累的标准程序。BMB是侵入性的，并探索骨髓的有限部分。F-18-FDG PET/CT目前广泛用于评估HL患者的治疗反应，并进行基线研究以提高准确性。这项回顾性分析的目的是评估常规BMB是否仍然需要伴随F-18-FDG PET/CT。所有患者均接受了增强CT、BMB和F-18-FDG PET/CT检查。在F-18-FDG PET/CT成像时，BMB的结果不可用。7例患者的BMB上有淋巴瘤浸润。4例患者在常规CT上有骨受累（2例BMB阴性）。所有常规分期的骨髓和/或骨病变患者也通过F-18-FDG PET/CT扫描诊断。PET/CT在另外9名患者中描绘了FDG-亲合性骨/骨髓病灶。其中4例仅有1个或2个病灶，另1例有多个病灶。然而，在F-18-FDG PET/CT上，髂嵴（BMB部位）未受累。在3名患者的PET/CT的CT部分上可见与FDG-亲合病灶匹配的溶骨性/硬化性病变。另外三名患者的MRI提示骨髓受累。治疗中期和/或结束时，F-18-FDG PET/CT记录了每位患者FDG-亲合性骨/骨髓病灶对化疗的反应。与传统分期相比，F-18-FDG PET/CT大大提高了HL中骨/骨髓病变诊断的灵敏度。
Accurate staging of Hodgkin's lymphoma (HL) is necessary in selecting appropriate treatment. Bone marrow trephine biopsy (BMB) is the standard procedure for depicting bone marrow involvement. BMB is invasive and explores a limited part of the bone marrow. F-18-FDG PET/CT is now widely used for assessing response to therapy in HL and a baseline study is obtained to improve accuracy. The aim of this retrospective analysis was to assess whether routine BMB remains necessary with concomitant F-18-FDG PET/CT.Data from 83 patients (newly diagnosed HL) were reviewed. All patients had received contrast-enhanced CT, BMB and F-18-FDG PET/CT. Results of BMB were not available at the time of F-18-FDG PET/CT imaging.Seven patients had lymphomatous involvement on BMB. Four patients had bone involvement on conventional CT (two with negative BMB). All patients with bone marrow and/or bone lesions at conventional staging were also diagnosed on F-18-FDG PET/CT scan. PET/CT depicted FDG-avid bone/bone marrow foci in nine additional patients. Four of them had only one or two foci, while the other had multiple foci. However, the iliac crest, site of the BMB, was not involved on F-18-FDG PET/CT. Osteolytic/sclerotic lesions matching FDG-avid foci were visible on the CT part of PET/CT in three patients. MRI ordered in three other patients suggested bone marrow involvement. Interim and/or end-therapy F-18-FDG PET/CT documented response of FDG-avid bone/bone marrow foci to chemotherapy in every patient.F-18-FDG PET/CT highly improves sensitivity for diagnosis of bone/bone marrow lesions in HL compared to conventional staging.