Kaddu-Mulindwa, Dominic and Altmann, Bettina and Held, Gerhard and Angel, Stephanie and Stilgenbauer, Stephan and Thurner, Lorenz and Bewarder, Moritz and Schwier, Maren and Pfreundschuh, Michael and Loffler, Markus and Menhart, Karin and Grosse, Jirka and Ziepert, Marita and Herrmann, Ken and Duhrsen, Ulrich and Huttmann, Andreas and Barbato, Francesco and Poeschel, Viola and Hellwig, Dirk (2021) FDG PET/CT to detect bone marrow involvement in the initial staging of patients with aggressive non-Hodgkin lymphoma: results from the prospective, multicenter PETAL and OPTIMAL > 60 trials. EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING, 48 (11). pp. 3550-3559. ISSN 1619-7070, 1619-7089
Full text not available from this repository. (Request a copy)Abstract
Purpose Fluorine-18 fluorodeoxyglucose positron emission tomography combined with computed tomography (FDG PET/CT) is the standard for staging aggressive non-Hodgkin lymphoma (NHL). Limited data from prospective studies is available to determine whether initial staging by FDG PET/CT provides treatment-relevant information of bone marrow (BM) involvement (BMI) and thus could spare BM biopsy (BMB). Methods Patients from PETAL (NCT00554164) and OPTIMAL>60 (NCT01478542) with aggressive B-cell NHL initially staged by FDG PET/CT and BMB were included in this pooled analysis. The reference standard to confirm BMI included a positive BMB and/or FDG PET/CT confirmed by targeted biopsy, complementary imaging (CT or magnetic resonance imaging), or concurrent disappearance of focal FDG-avid BM lesions with other lymphoma manifestations during immunochemotherapy. Results Among 930 patients, BMI was detected by BMB in 85 (prevalence 9%) and by FDG PET/CT in 185 (20%) cases, for a total of 221 cases (24%). All 185 PET-positive cases were true positive, and 709 of 745 PET-negative cases were true negative. For BMB and FDG PET/CT, sensitivity was 38% (95% confidence interval [CI]: 32-45%) and 84% (CI: 78-88%), specificity 100% (CI: 99-100%) and 100% (CI: 99-100%), positive predictive value 100% (CI: 96-100%) and 100% (CI: 98-100%), and negative predictive value 84% (CI: 81-86%) and 95% (CI: 93-97%), respectively. In all of the 36 PET-negative cases with confirmed BMI patients had other adverse factors according to IPI that precluded a change of standard treatment. Thus, the BMB would not have influenced the patient management. Conclusion In patients with aggressive B-cell NHL, routine BMB provides no critical staging information compared to FDG PET/CT and could therefore be omitted.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | B-CELL LYMPHOMA; FDG PET; CT; Lymphoma; Aggressive B-cell lymphoma; Bone marrow biopsy; Diagnostic performance |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Abteilung für Nuklearmedizin |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 16 Sep 2022 16:40 |
| Last Modified: | 16 Sep 2022 16:40 |
| URI: | https://pred.uni-regensburg.de/id/eprint/47576 |
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