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

URN to cite this document:

urn:nbn:de:bvb:355-epub-564165 Copy

DOI to cite this document:

10.5283/epub.56416 Copy

Kaddu-Mulindwa, Dominic ; Altmann, Bettina ; Held, Gerhard ; Angel, Stephanie ; Stilgenbauer, Stephan ; Thurner, Lorenz ; Bewarder, Moritz ; Schwier, Maren ; Pfreundschuh, Michael ; Löffler, Markus ; Menhart, Karin ; Grosse, Jirka ; Ziepert, Marita ; Herrmann, Ken ; Dührsen, Ulrich ; Hüttmann, Andreas ; Barbato, Francesco ; Poeschel, Viola ; Hellwig, Dirk

License: Creative Commons Attribution 4.0 PDF - Published Version (1MB)

Date of publication of this fulltext: 29 Feb 2024 12:28

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Details

Item type:	Article
Open Access Type:	DEAL (Springer) - Non UR
Journal or Publication Title:	European Journal of Nuclear Medicine and Molecular Imaging
Publisher:	Springer
Place of Publication:	NEW YORK
Volume:	48
Number of Issue or Book Chapter:	11
Page Range:	pp. 3550-3559
Date:	29 April 2021
Institutions:	Medicine > Abteilung für Nuklearmedizin
Identification Number:	Value Type 10.1007/s00259-021-05348-6 DOI
Keywords:	B-CELL LYMPHOMA; FDG PET; CT; Lymphoma; Aggressive B-cell lymphoma; Bone marrow biopsy; Diagnostic performance
Dewey Decimal Classification:	600 Technology > 610 Medical sciences Medicine
Status:	Published
Refereed:	Yes, this version has been refereed
Created at the University of Regensburg:	Yes
Item ID:	56416

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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). ...

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.

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Metadata last modified: 25 Apr 2024 09:35

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