Prospective Assessment of Bone Marrow Involvement with Positron Emission Tomography vs Bone Marrow Biopsy in Patients with Lymphoma

IF 0.9 4区医学 Indian Journal of Hematology and Blood Transfusion Pub Date : 2024-09-11 DOI:10.1007/s12288-024-01869-w

Suhas Singla, Sandeep Batra, Pankaj Dougall, Nitin Dayal, Rahul Naithani

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Abstract

Bone marrow (BM) involvement in lymphoma is a known adverse prognostic factor. Bone marrow biopsy (BMB) is the gold standard for detection of bone marrow involvement but is invasive modality. Positron emission tomography with computed tomography (PET-CT) scan has the ability to assess bone marrow involvement. We aimed to assess the concordance of PET-CT for BM involvement with BMB. 75 consecutive newly diagnosed cases of lymphoma were enrolled and were assessed for BM involvement with PET-CT and BMB. Of 75 patients, eighteen patients (24%) had BM involvement, with 19% (n = 14) detected with BMB, and 13 (17%) with FDG PET CT. There was a concordance rate of 88% amongst PET-CT and BMB. It was 92% in Hodgkin's lymphoma (HL), 71.4% in non-Hodgkin's lymphoma (NHL), and 91% and 70% in high- grade (HG) and low- grade (LG) NHL, respectively. Sensitivity, specificity, PPV, NPV, and accuracy of PET-CT for study population were 69.23%, 93.44%, 69.23%, 93.44%, and 89.19% respectively. In patients with NHL sensitivity, specificity, NPV, PPV, and accuracy of PET-CT were 54.55%, 94.23%, 66.67%, 90.74%, and 87.30%, respectively; whereas in HL group these were 100%, 88.89%,75%, 100%, and 91.67%, respectively. PET-CT has got a high concordance with bone marrow biopsy in detecting bone marrow involvement with high specificity, NPV and accuracy. A high sensitivity, specificity, NPV and accuracy for detecting bone marrow involvement in patients with HL, aggressive B cell NHL, and T cell NHL was observed but the same parameters were not at par in patient with indolent NHL.

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利用正电子发射断层扫描与骨髓活检对淋巴瘤患者骨髓受累情况进行前瞻性评估

淋巴瘤的骨髓受累是一个已知的不良预后因素。骨髓活检（BMB）是检测骨髓受累的金标准，但属于侵入性检查。正电子发射计算机断层扫描（PET-CT）可评估骨髓受累情况。我们的目的是评估 PET-CT 与 BMB 检测骨髓受累的一致性。我们选取了 75 例连续的新诊断淋巴瘤病例，用 PET-CT 和 BMB 评估其骨髓受累情况。在75名患者中，18名患者（24%）有骨髓受累，其中19%（n = 14）通过BMB检测到，13名（17%）通过FDG PET CT检测到。PET-CT 和 BMB 的吻合率为 88%。霍奇金淋巴瘤（HL）的吻合率为 92%，非霍奇金淋巴瘤（NHL）为 71.4%，高级别（HG）和低级别（LG）NHL 的吻合率分别为 91% 和 70%。研究人群 PET-CT 的敏感性、特异性、PPV、NPV 和准确性分别为 69.23%、93.44%、69.23%、93.44% 和 89.19%。在 NHL 患者中，PET-CT 的敏感性、特异性、NPV、PPV 和准确性分别为 54.55%、94.23%、66.67%、90.74% 和 87.30%；而在 HL 组中，PET-CT 的敏感性、特异性、NPV、PPV 和准确性分别为 100%、88.89%、75%、100% 和 91.67%。在检测骨髓受累方面，PET-CT 与骨髓活检具有很高的一致性，特异性、NPV 和准确性都很高。在检测HL、侵袭性B细胞NHL和T细胞NHL患者的骨髓受累方面，PET-CT具有较高的灵敏度、特异性、NPV和准确性，但在检测非侵袭性NHL患者的骨髓受累方面，这些参数却不尽相同。

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Indian Journal of Hematology and Blood Transfusion Medicine-Hematology

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期刊介绍： Indian Journal of Hematology and Blood Transfusion is a medium for propagating and exchanging ideas within the medical community. It publishes peer-reviewed articles on a variety of aspects of clinical hematology, laboratory hematology and hemato-oncology. The journal exists to encourage scientific investigation in the study of blood in health and in disease; to promote and foster the exchange and diffusion of knowledge relating to blood and blood-forming tissues; and to provide a forum for discussion of hematological subjects on a national scale. The Journal is the official publication of The Indian Society of Hematology & Blood Transfusion.