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Revista de investigación clínica
versión On-line ISSN 2564-8896versión impresa ISSN 0034-8376
Resumen
AGUADO-VAZQUEZ, Tania M. et al. 18f-Fluorodeoxyglucose Positron Emission Tomography Versus Bone Marrow Biopsy for the Evaluation of Bone Marrow Infiltration in Newly Diagnosed Lymphoma Patients. Rev. invest. clín. [online]. 2021, vol.73, n.2, pp.79-86. Epub 14-Mayo-2021. ISSN 2564-8896. https://doi.org/10.24875/ric.20000239.
Background:
Bone marrow evaluation (BME) is crucial for establishing an accurate staging and prognosis in lymphoma patients.
Objective:
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.
Methods:
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.
Results:
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.
Conclusions:
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.
Palabras llave : Bone marrow infiltration; Bone marrow biopsy; 18F-Fluorodeoxyglucose; Positron Emission Tomography; Lymphoma.