Comparison of bone marrow biopsy and fluorodeoxyglucose-positron emission tomography for the assessment of bone marrow infiltration in children with Hodgkin’s lymphoma

Abstract

Purpose To compare bone marrow biopsy (BMB) with [18F]-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (PET/CT) imaging in the demonstration of bone marrow involvement in children with Hodgkin’s Lymphoma (HL) and to investigate the effectiveness of PET/CT imaging and thus the necessity for BMB at staging.

Methods Pediatric patients with HL, who underwent both bilateral iliac BMB and PET/CT imaging at disease staging were retrospectively analyzed. In determining bone marrow involvement (BMinv), BMB and/or first/follow-up PET/CT imaging were eligible for review.

Results Fifty-six patients were included. BMinv was detected by PET/CT imaging in 6/56 (10.7%), whereas the proportion was 3/56 (5.3%) in BMB specimens. Bone marrow biopsies and PET/CT images were concordant in 53/56 (94.6%) patients with BMB specimens missing three cases of BMinv detected by PET/CT. When diagnostic accuracy was calculated, sensitivity, specificity, positive predictive value and negative predictive values for PET/CT were 100%, 100%, 100%, 100%, respectively, and the same values for BMB were 50%, 100%, 100%, 94.3%, respectively.

Conclusions The results of PET/CT and BMB for staging of pediatric HL patients were compatible, and PET/CT imaging was found to provide high diagnostic performance in determining BMinv. In keeping with earlier research, the current study showed that BMB may not be necessary in every patient at staging, and should be reserved for cases where PET/CT is inconclusive.

Zusammenfassung

Ziel Vergleich der Knochenmarkbiopsie (KMB) mit [18F]Fluoro-2-Desoxyglukose-Positronen-Emissions-Tomografie/Computertomografie (PET/CT) zum Nachweis der Knochenmarkinfiltration bei Kindern mit Hodgkin-Lymphom (HL) und um die Wirksamkeit von PET/CT und damit die Notwendigkeit von KMB beim Staging zu untersuchen.

Methoden Pädiatrische Patienten mit HL, die sich sowohl einer bilateralen iliakalen KMB als auch einer PET/CT-Bildgebung für das Staging unterzogen, wurden retrospektiv analysiert. Bei der Bestimmung der Knochenmarkinfiltration (KMinv) wurden KMB und/oder Erst-/Folge-PET/CT-Bildgebung berücksichtigt.

Ergebnisse 56 Patienten wurden in die Studie eingeschlossen. KMinv wurde in der PET/CT-Bildgebung bei 6/56 (10,7%) Patienten nachgewiesen, verglichen mit 3/56 (5,3%) Patienten in den KMB-Proben. PET/CT- und KMB-Ergebnisse waren bei 53/56 Patienten kompatibel, 3 Patienten mit KMinv bei PET/CT wurden bei KMB nicht erkannt. Bei der Berechnung der diagnostischen Genauigkeit betrugen Sensitivität, Spezifität, positiver Vorhersagewert und negativer Vorhersagewert für PET/CT 100%, 100%, 100% bzw. 100%, und die gleichen Werte für BMB waren 50%, 100%, 100% bzw. 94,3%.

Schlussfolgerungen Die Ergebnisse von PET/CT und BMB für das Staging von pädiatrischen HL-Patienten waren kompatibel, und die PET/CT-Bildgebung erwies sich als hochgradig diagnostisch bei der Bestimmung einer Knochenmarkinfiltration. In Übereinstimmung mit früheren Studien zeigte die aktuelle Studie, dass eine KMB nicht bei jedem Patienten zum Staging erforderlich sein könnte und Fällen vorbehalten bleiben sollte, in denen die PET/CT nicht schlüssig ist.

Schlüsselwörter

Hodgkin-Lymphom - Positronen-Emissions-Tomographie - Knochenmarkbiopsie - Lymphom-Staging - Kind

Keywords

Hodgkin’s lymphoma - Positron emission tomography - Bone marrow biopsy - Lymphoma staging - child

Publication History

Received: 13 July 2022

Accepted after revision: 03 November 2022

Article published online:
06 February 2023

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