scholarly journals Diagnostic accuracy of pelvic magnetic resonance imaging for the assessment of bone marrow involvement in diffuse large B-cell lymphoma

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0252226
Author(s):  
Qing Ke ◽  
Cheng-Cheng Liao ◽  
Xiao-Hong Tan ◽  
Bao-Ping Guo ◽  
Hong Cen ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Cell Lymphoma ◽  
Bone Marrow Involvement ◽  
B Cell Lymphoma ◽  
Diagnostic Value ◽  
Whole Body ◽  
Pelvic Mri ◽  
Pelvic Magnetic Resonance Imaging ◽  
Large B Cell Lymphoma ◽  
Pet Ct

Purpose We investigated the efficacy of pelvic magnetic resonance imaging (MRI) in the diagnosis of bone marrow involvement (BMinv) in diffuse large B-cell lymphoma (DLBCL) patients. Patients and methods This was a retrospective study of data from a previous study (NCT02733887). We included 171 patients who underwent bone marrow biopsy (BMB) and bone marrow smear (BMS), pelvic MRI, and whole-body positron emission tomography-computed tomography (PET/CT) from January 2016 to December 2019 at a single center. BMB/BMS and whole-body PET/CT results were used as reference standards against which we calculated the diagnostic value of pelvic MRI for BMinv in DLBCL patients. A chi-square test was used to compare detection rates, and a receiver operating characteristic curve was used to evaluate diagnostic value of pelvic MRI. Propensity-score matching was performed according to clinical information, and Kaplan-Meier curves were constructed to compare progression-free survival (PFS) and overall survival (OS) of patients. Results The BMinv detection rate of pelvic MRI (42/171) was higher (P = 0.029) than that of BMB/BMS (25/171), and similar to that of PET/CT (44/171; P = 0.901). The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of pelvic MRI were 83.33%, 98.37%, 94.15%, 95.24%, and 93.80%, respectively. Median PFS values were as follows: BMB/BMS-positive, 17.8 months vs. BMB/BMS-negative, 26.9 months (P = 0.092); PET/CT-positive, 24.8 months vs. PET/CT-negative, 33.0 months (P = 0.086); pelvic MRI-positive, 24.9 months vs. pelvic MRI-negative, 33.1 months (P<0.001). Median OS values were as follows: BMB/BMS-positive, 22.3 months vs. BMB/BMS-negative, 29.8 months (P = 0.240); PET/CT-positive, 27.9 months vs. PET/CT-negative, 33.9 months (P = 0.365); pelvic MRI-positive, 27.3 months vs. pelvic MRI-negative, 35.8 months (P = 0.062). Conclusion Pelvic MRI is effective for detecting BMinv in DLBCL patients, providing a more accurate indication of PFS than BMB/BMS and PET/CT do. It may ultimately be used to improve the accuracy of clinical staging, guide patient treatment, and evaluate prognosis.

scholarly journals Diagnostic accuracy and prognostic relevance of immunoglobulin heavy chain rearrangement and 18 F-FDG- PET/CT compared with unilateral bone marrow trephination for detecting bone marrow involvement in patients with diffuse large B-cell lymphoma

2021 ◽  
Author(s):  
Mihee Kim ◽  
Seo-Yeon Ahn ◽  
Jae-Sook Ahn ◽  
Ga-Young Song ◽  
Sung-Hoon Jung ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Diagnostic Accuracy ◽  
Heavy Chain ◽  
Cell Lymphoma ◽  
Bone Marrow Involvement ◽  
B Cell Lymphoma ◽  
Large B Cell Lymphoma ◽  
Pet Ct ◽  
Igh Rearrangement ◽  
Large B Cell

Abstract Background In diffuse large B-cell lymphoma (DLBCL), bone marrow involvement (BMI) has an important clinical implication as a component of staging and International Prognostic Index (IPI). Methods This study aimed to determine whether molecular analysis of immunoglobulin heavy chain (IgH) genes and PET/CT could overcome the limitation of defining morphologic bone marrow involvement by trephination biopsy and could increase the diagnostic accuracy or prognostic prediction. 94 de novo patients with DLBCL underwent PET/CT, polymerase chain reaction (PCR) test for detection of IgH gene rearrangement, and unilateral BM trephination at diagnosis. Results 9 patients (9.6%) were confirmed to present morphologic BMI (mBMI) based on trephination biopsy. On the other hands, 21 patients (22.3%) were confirmed to have IgH clonality (IgH BMI), while 16 (17.0%) were classified with BMI based on the assessment of PET/CT (PET BMI). Each IgH rearrangement PCR and PET/CT showed the high negative predict value of detecting the BMI. However, the combined assessment of IgH rearrangement and PET/CT could increase a diagnostic accuracy and specificity with 87.2% and 97.0%, respectively. The survival outcome of patients with double positive PET BMI and IgH BMI was significantly worse than that with either single positive PET BMI or IgH BMI, and even less than patients with neither PET BMI nor IgH BMI. (3-year PFS: 50.0% vs 75.4% vs 97.9%, p = 0.007, 3-year OS: 50.0% vs 75.6% vs 80.1%, p = 0.035, respectively). Conclusion This study suggested that the combined evaluation of PET/CT and IgH rearrangement could give additional information of predicting therapeutic outcomes in patients with negative morphologic BMI as an important part of the prognosis.

scholarly journals The role of FDG-PET/CT in detecting bone marrow involvement in diffuse large b-cell lymphoma

2017 ◽  
Vol 28 ◽  
pp. v362
Author(s):  
A. Bulbul ◽  
E.A. Mino ◽  
S. Chouial ◽  
A. Bautista ◽  
A. Mustafa ◽  
...  
Keyword(s):  
Bone Marrow ◽  
B Cell ◽  
Cell Lymphoma ◽  
Bone Marrow Involvement ◽  
B Cell Lymphoma ◽  
Large B Cell Lymphoma ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Large B Cell

Role of FDG-PET/CT in detecting lymphomatous bone marrow involvement in patients with newly diagnosed diffuse large B-cell lymphoma

2011 ◽  
Vol 91 (5) ◽  
pp. 687-695 ◽  
Author(s):  
Junshik Hong ◽  
Yukyung Lee ◽  
Yeonjeong Park ◽  
Seog Gyun Kim ◽  
Kyung Hoon Hwang ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Cell Lymphoma ◽  
Bone Marrow Involvement ◽  
B Cell Lymphoma ◽  
Newly Diagnosed ◽  
Large B Cell Lymphoma ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Large B Cell

scholarly journals The Role of Integrated Positron Emission Tomography/Computed Tomography (PET/CT) and Bone Marrow Examination in Staging Large B-Cell Lymphoma

2020 ◽  
Vol 14 ◽  
pp. 117955492095309
Author(s):  
Ahmad Al-Sabbagh ◽  
Feryal Ibrahim ◽  
Lajos Szabados ◽  
Dina S Soliman ◽  
Ruba Y Taha ◽  
...  
Keyword(s):  
Bone Marrow ◽  
B Cell ◽  
Bone Marrow Biopsy ◽  
Predictive Value ◽  
Cell Lymphoma ◽  
Bone Marrow Involvement ◽  
B Cell Lymphoma ◽  
Large B Cell Lymphoma ◽  
Pet Ct ◽  
Large B Cell

Introduction: In the era of routine use of positron emission tomography/computed tomography (PET/CT) for staging, it is not yet clear whether PET/CT can replace bone marrow biopsy for the assessment of bone marrow involvement in large B-cell lymphoma. Objectives: To compare the clinical utility of bone marrow biopsy and PET/CT scanning in the staging of large B-cell lymphoma. Methods: This was a retrospective analysis of all patients who presented to single center over a 4-year period with large B-cell lymphoma who had concurrent PET/CT and bone marrow biopsy performed in the assessment and staging of the lymphoma. Results: Out of 89 patients, 24 had bone marrow involvement either by PET/CT, by bone marrow biopsy, or by both. Bone marrow biopsy identified 12 patients (sensitivity 50%, specificity 100%, negative predictive value 84%), whereas PET/CT identified 23 patients (sensitivity 96%, specificity 100%, negative predictive value 98%). No patients were upstaged by the bone marrow biopsy result, and no patients had their treatment plan changed based on the bone marrow biopsy result. Conclusion: The results show that PET-CT is more sensitive and has better negative predictive value than bone marrow biopsy. This suggests that PET-CT could replace bone marrow biopsy in detecting bone marrow involvement for staging of large B-cell lymphoma.

scholarly journals Use of FDG PET/CT in identification of bone marrow involvement in diffuse large B cell lymphoma and follicular lymphoma: comparison with iliac crest bone marrow biopsy

2017 ◽  
Vol 58 (12) ◽  
pp. 1476-1484 ◽  
Author(s):  
Alexandra R Teagle ◽  
Hannah Barton ◽  
Elizabeth Charles-Edwards ◽  
Sabina Dizdarevic ◽  
Timothy Chevassut
Keyword(s):  
Bone Marrow ◽  
Fdg Pet ◽  
Cell Lymphoma ◽  
Bone Marrow Involvement ◽  
B Cell Lymphoma ◽  
Reference Standard ◽  
Large B Cell Lymphoma ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Large B Cell

Background Non-Hodgkin’s lymphoma (NHL) accounts for around 4% of new cancer cases annually. Bone marrow involvement is important for staging and management. Fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) is used increasingly to identify this, in addition to bone marrow biopsy (BMB), which is seen as “gold” reference standard. Purpose To compare determination of bone marrow involvement by FDG PET/CT against BMB in diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL). Material and Methods This was a retrospective study of patients with histologically confirmed NHL at a single UK cancer center undergoing pre-treatment FDG PET/CT and BMB between June 2010 and February 2013. Information was collected from patient notes, cancer registry, histological and imaging reports. Diagnostic accuracy of FDG PET/CT was determined, compared to BMB as the reference standard. Results Twenty-four patients with DLBCL and 12 with FL were included. Five DLBCL patients had bone marrow involvement on PET/CT; all were confirmed on BMB. Three FL patients had marrow involvement on PET/CT but not on BMB; one FL patient had positive BMB but negative PET/CT. Using BMB as the reference standard, the sensitivity and specificity of FDG PET/CT for detecting bone marrow involvement in DLBCL were 100% and 100%, respectively, and in FL were 0% and 72.7%, respectively. Conclusion FDG PET/CT is accurate for detection of bone marrow involvement in newly diagnosed DLBCL, but not FL. In DLBCL, positive FDG PET/CT may negate the need for routine BMB, although BMB in addition or combination may be appropriate if this would influence management or prognosis.

scholarly journals Bone Marrow Biopsy Is Still Indispensable for Evaluating Bone Marrow Involvement in DLBCL Patients Even in the PET/CT Era

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 5403-5403
Author(s):  
Yusuke Saiki ◽  
Naoto Tomita ◽  
Akiko Uchida ◽  
Satoshi Yokoi ◽  
Yuji Nishio ◽  
...  
Keyword(s):  
Bone Marrow ◽  
B Cell ◽  
Bone Marrow Biopsy ◽  
Cell Lymphoma ◽  
Bone Marrow Involvement ◽  
B Cell Lymphoma ◽  
Large B Cell Lymphoma ◽  
Pet Ct ◽  
Significant Difference ◽  
Large B Cell

Abstract Background: Initial staging by positron emission tomography/computed tomography (PET/CT) is recommended for lymphoma of fluorodeoxyglucose (FDG)-avid histology, such as diffuse large B-cell lymphoma (DLBCL). Although both PET/CT and bone marrow biopsy (BMB) are usually performed to determine the bone marrow involvement in DLBCL, whether PET/CT alone is sufficient remains controversial. While previous reports discussing this point have used data based on medical records, here we performed a systematic review of untreated DLBCL patients, for whom a radiologist and a hematopathologist separately performed blind reviews. Methods: The subjects had DLBCL diagnosed between 2008 and 2017 for which both PET/CT and BMB were performed for staging before initiation of treatment. We excluded cases in which BMB specimens were qualitatively and/or quantitatively insufficient to determine the presence or absence of bone marrow involvement. To exclude follicular lymphoma, we did not include patients whose diagnostic specimens of lymphoma included any degree of nodular growth pattern. All PET/CT scans were performed in a single institution. In PET/CT, cases with score 4 or 5 in the Deauville criteria in bone marrow were classified as positive. In the review of BMB, we used both hematoxylin-eosin staining and CD20 immunostaining specimens in all cases to determine the involvement. We treated the presence of bone marrow involvement by BMB as a reference, and the involvement type was classified as either concordant or discordant pattern. Survival curves were compared by the log-rank test. A P-value less than 0.05 was considered to indicate a significant difference. Results: The study included 87 untreated patients with DLBCL (82 DLBCL, NOS; 3 intravascular large B-cell lymphoma; and 2 primary mediastinal large B-cell lymphoma), comprising 46 males and 41 females. The median age at the time of diagnosis was 71 (range, 19 to 87 years). The number of positive cases in PET/CT and BMB was 17 (20%) and 24 (28%), respectively (Table). Nine (10%) cases had both positive results. Among BMB-positive cases, there were18 concordant and 6 discordant involvements. When considering BMB results as a reference, PET/CT showed 38% sensitivity and 87% for specificity. The positive and negative predictive values were 53% and 79%, respectively. In 61 patients initially treated with R-CHOP, there was no significant difference in progression-free survival (PFS) between positive and negative cases in PET/CT (P = 0.16) , but PFS was significantly worse for BMB-positive cases than BMB-negative cases (P = 0.03). Conclusion: BMB is still mandatory in patients with untreated DLBCL and predicts outcome in the era of PET/CT. Routine CD20 immunostaining might be helpful in detecting lymphoma involvement in BMB specimens. Table. Table. Disclosures No relevant conflicts of interest to declare.

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