European Journal of Nuclear Medicine and Molecular Imaging

, Volume 37, Issue 6, pp 1095–1105

18F-FDG PET/CT bone/bone marrow findings in Hodgkin’s lymphoma may circumvent the use of bone marrow trephine biopsy at diagnosis staging

  • Gerard Moulin-Romsee
  • Elif Hindié
  • Xavier Cuenca
  • Pauline Brice
  • Didier Decaudin
  • Myriam Bénamor
  • Josette Brière
  • Marcela Anitei
  • Jean-Emmanuel Filmont
  • David Sibon
  • Eric de Kerviler
  • Jean-Luc Moretti
Original Article

DOI: 10.1007/s00259-009-1377-5

Cite this article as:
Moulin-Romsee, G., Hindié, E., Cuenca, X. et al. Eur J Nucl Med Mol Imaging (2010) 37: 1095. doi:10.1007/s00259-009-1377-5

Abstract

Purpose

Accurate staging of Hodgkin’s lymphoma (HL) is necessary in selecting appropriate treatment. Bone marrow trephine biopsy (BMB) is the standard procedure for depicting bone marrow involvement. BMB is invasive and explores a limited part of the bone marrow. 18F-FDG PET/CT is now widely used for assessing response to therapy in HL and a baseline study is obtained to improve accuracy. The aim of this retrospective analysis was to assess whether routine BMB remains necessary with concomitant 18F-FDG PET/CT.

Methods

Data from 83 patients (newly diagnosed HL) were reviewed. All patients had received contrast-enhanced CT, BMB and 18F-FDG PET/CT. Results of BMB were not available at the time of 18F-FDG PET/CT imaging.

Results

Seven patients had lymphomatous involvement on BMB. Four patients had bone involvement on conventional CT (two with negative BMB). All patients with bone marrow and/or bone lesions at conventional staging were also diagnosed on 18F-FDG PET/CT scan. PET/CT depicted FDG-avid bone/bone marrow foci in nine additional patients. Four of them had only one or two foci, while the other had multiple foci. However, the iliac crest, site of the BMB, was not involved on 18F-FDG PET/CT. Osteolytic/sclerotic lesions matching FDG-avid foci were visible on the CT part of PET/CT in three patients. MRI ordered in three other patients suggested bone marrow involvement. Interim and/or end-therapy 18F-FDG PET/CT documented response of FDG-avid bone/bone marrow foci to chemotherapy in every patient.

Conclusion

18F-FDG PET/CT highly improves sensitivity for diagnosis of bone/bone marrow lesions in HL compared to conventional staging.

Keywords

Hodgkin’s lymphomaPET/CT18F-FDGBone marrow trephine biopsyStaging

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Gerard Moulin-Romsee
    • 1
    • 2
  • Elif Hindié
    • 1
  • Xavier Cuenca
    • 3
  • Pauline Brice
    • 3
  • Didier Decaudin
    • 4
  • Myriam Bénamor
    • 2
  • Josette Brière
    • 5
  • Marcela Anitei
    • 4
  • Jean-Emmanuel Filmont
    • 1
  • David Sibon
    • 3
  • Eric de Kerviler
    • 6
  • Jean-Luc Moretti
    • 1
  1. 1.Service de Médicine Nucléaire, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de ParisUniversité Paris 7Paris cedex 10France
  2. 2.Nuclear MedicineInstitut CurieParisFrance
  3. 3.Haemato-OncologyHôpital Saint-LouisParisFrance
  4. 4.HaematologyInstitut CurieParisFrance
  5. 5.PathologyHôpital Saint-LouisParisFrance
  6. 6.RadiologyHôpital Saint-LouisParisFrance