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

Original Article



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.


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.


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.


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.


Lymphoma Pediatrics FDG PET/CT Bone marrow biopsy 


Conflicts of interest



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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  1. 1.Department of RadiologyHospital of the University of PennsylvaniaPhiladelphiaUSA
  2. 2.Department of Diagnostic Radiology and Nuclear MedicineUniversity of Maryland Medical CenterBaltimoreUSA
  3. 3.Children’s Hospital of PhiladelphiaPhiladelphiaUSA

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