European Journal of Nuclear Medicine and Molecular Imaging

, Volume 38, Issue 8, pp 1469–1476

Biopsy versus FDG PET/CT in the initial evaluation of bone marrow involvement in pediatric lymphoma patients

Authors

    • Department of RadiologyHospital of the University of Pennsylvania
  • Wengen Chen
    • Department of Diagnostic Radiology and Nuclear MedicineUniversity of Maryland Medical Center
  • Wichana Chamroonrat
    • Department of RadiologyHospital of the University of Pennsylvania
  • Drew A. Torigian
    • Department of RadiologyHospital of the University of Pennsylvania
  • Hongming Zhuang
    • Children’s Hospital of Philadelphia
    • Department of RadiologyHospital of the University of Pennsylvania
Original Article

DOI: 10.1007/s00259-011-1815-z

Cite this article as:
Cheng, G., Chen, W., Chamroonrat, W. et al. Eur J Nucl Med Mol Imaging (2011) 38: 1469. doi:10.1007/s00259-011-1815-z

Abstract

Purpose

The objective is to assess the role of 18F-2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET)/CT versus bone marrow biopsy (BMB) in the initial evaluation of bone marrow (BM) involvement in pediatric lymphoma patients.

Methods

Fifty-four pediatric patients with pathologically proven lymphoma [31 Hodgkin’s disease (HD), 23 non-Hodgkin’s lymphoma (NHL)] were included in this study. All patients had soft tissue biopsy and BMB and had FDG PET/CT scans within 2 weeks of biopsy.

Results

Among the 31 HD patients, FDG PET/CT revealed positive BM involvement in 4 patients, while BMB revealed BM involvement in 2 patients who were also positive on FDG PET/CT imaging. Among the 23 NHL patients, FDG PET/CT revealed positive BM involvement in 8 patients, while biopsy revealed BM involvement in 5 patients on initial studies (4 of them were also positive on FDG PET/CT, and 1 was BMB positive but was negative on FDG PET/CT), plus 1 false-negative BMB study initially but positive on repeat biopsy after FDG PET/CT. The overall sensitivity of detecting BM involvement by lymphoma was 92 and 54% (p < 0.05) for FDG PET/CT and BMB, respectively. It is noted that there were more positive BMB findings in patients with abnormal FDG activities seen in the biopsy sites on PET/CT.

Conclusion

Our study demonstrates that FDG PET/CT has high sensitivity and accuracy and a substantial complementary value to BMB in the initial diagnosis of pediatric lymphoma, and should be employed as a first-line study.

Keywords

LymphomaPediatricsFDG PET/CTBone marrow biopsy

Copyright information

© Springer-Verlag 2011