scholarly journals Revisiting the Marrow Metabolic Changes after Chemotherapy in Lymphoma: A Step towards Personalized Care

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Bingfeng Tang ◽  
Malaykumar M. Patel ◽  
Regina H. Wong ◽  
Daniel Wood ◽  
Christiana O. Wong ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Fdg Pet ◽  
Bone Marrow Involvement ◽  
Standardized Uptake Value ◽  
B Cell Lymphoma ◽  
Metabolic Changes ◽  
Personalized Care ◽  
Pet Ct ◽  
Maximal Standardized Uptake Value ◽  
Fdg Pet Ct

Purpose. The aims were to correlate individual marrow metabolic changes after chemotherapy with bone marrow biopsy (BMBx) for its potential value of personalized care in lymphoma. Methods. 26 patients (mean age, 58 ± 15 y; 13 female, 13 male) with follicular lymphoma or diffuse large B-cell lymphoma, referred to FDG-PET/CT imaging, who had BMBx from unilateral or bilateral iliac crest(s) before chemotherapy, were studied retrospectively. The maximal standardized uptake value (SUV) was measured from BMBx site over the same area on both initial staging and first available restaging FDG-PET/CT scan. Results. 35 BMBx sites in 26 patients were evaluated. 12 of 35 sites were BMBx positive with interval decrease in SUV in 11 of 12 sites (92%). The remaining 23 of 35 sites were BMBx negative with interval increase in SUV in 21 of 23 sites (91%). The correlation between SUV change over the BMBx site before and after chemotherapy and BMBx result was significant (P<0.0001). Conclusions. This preliminary result demonstrates a strong correlation between marrow metabolic changes (as determined by FDG PET) after chemotherapy and bone marrow involvement proven by biopsy. This may provide a retrospective means of personalized management of marrow involvement in deciding whether to deliver more extended therapy or closer followup of lymphoma patients.

scholarly journals Diagnostic Accuracy of Immunoglobulin Heavy Chain Rearrangement, FDG-PET/CT and Unilateral Bone Marrow Trephination for Detecting Bone Marrow Involvement in Diffuse Large B Cell Lymphoma

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 4236-4236
Author(s):  
Seung-Yeon Jung ◽  
Sung-Hoon Jung ◽  
Seo-Yeon Ahn ◽  
Je-Jung Lee ◽  
Hyeoung-Joon Kim ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Diagnostic Accuracy ◽  
Fdg Pet ◽  
Bone Marrow Involvement ◽  
B Cell Lymphoma ◽  
Large B Cell Lymphoma ◽  
Pet Ct ◽  
Igh Rearrangement ◽  
Low Sensitivity ◽  
Fdg Pet Ct

Abstract Bone marrow involvement (BMI) has important clinical implication in diffuse large B cell lymphoma (DLBCL) as a component of staging and International Prognostic Index (IPI). However, there are some limitations of BMI assessment using iliac bony trephination, such as low sensitivity to patchy or focal lymphomatous involvement, inter-observers variability, inappropriately obtained specimens in terms of technical problem. This study investigated that whether the combined evaluation with 18F-FDG PET/CT and molecular analysis of monoclonal Immunoglobulin heavy chain (IgH) rearrangement could increase the diagnostic accuracy of BMI at the time of diagnosis in DLBCL. Methods This observational study conducted in 100 patients with newly diagnosed DLBCL from January 2017 to May 2018 from single institution. The specimens for IgH rearrangement polymerase chain reaction (PCR) to detect the clonality were obtained by fine-needle aspiration and unilateral trephination biopsy. In addition, 18F-FDG PET/CT assessment was performed at the time of diagnosis and classified into two patterns (focal vs diffuse) based on the type of bony FDG uptakes. The section specimens were reviewed by hematopathologists according to the World Health Organization (WHO) classification. Results 53 patients were diagnosed with advanced stage and 9 patients (9%) were confirmed morphologic BMI (mBMI) by section biopsy. IgH monoclonality (IgH BMI) was detected in 17 patients (17%) and bony involvement on PET/CT assessment (PET BMI) was observed in 16 patients (16%), respectively. All nine patients with mBMI were linked together with either IgH BMI or PET BMI. Of 17 patients with IgH BMI, 6 patients (35.2%) were concordant with mBMI. Overall diagnostic accuracy of IgH BMI for detection of mBMI was 86%, and it`s sensitivity and specificity was 66.7% and 87.9% with 96.4% of negative predictve value (NPV), respectively. In addition, among the patients with PET BMI, 11 patients were sub-classified into focal type (68.8%, 11/16) with median 7.9 of SUVmax compared to diffuse type with median 5.6 of SUVmax. 5 patients (31.3%, 5/16) were concordant with mBMI. Two of these five concordant cases were focal type. PET/CT assessment showed 85% of diagnostic accuracy with 55.6% of sensitivity, 87.9% of specificity and 95.2% of NPV, respectively. However, the combination of IgH rearrangement with PET/CT assessment resulted in 100% of sensitivity and 79.1% of specificity with 100% of NPV, respectively. Total 28 patients had positive results either IgH rearrangement or PET BMI. 11 patients showed only PET BMI, and another 12 showed only IgH BMI. Conclusion Each PET/CT assessment and PCR-technique for IgH rearrangement was associated with low sensitivity and high NPV for detecting mBMI. However, combined evaluation with IgH monoclonality and initial PET/CT could give more information to predict bone marrow involvement of DLBCL Disclosures No relevant conflicts of interest to declare.

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 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

2021 ◽  
Author(s):  
Dominic Kaddu-Mulindwa ◽  
Bettina Altmann ◽  
Gerhard Held ◽  
Stephanie Angel ◽  
Stephan Stilgenbauer ◽  
...  
Keyword(s):  
Bone Marrow ◽  
B Cell ◽  
Hodgkin Lymphoma ◽  
Predictive Value ◽  
Fdg Pet ◽  
Bone Marrow Involvement ◽  
Non Hodgkin Lymphoma ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Initial Staging

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. Trial registration NCT00554164 and NCT01478542

scholarly journals Pulmonary Findings of [18F]FDG PET/CT Images on Asymptomatic COVID-19 Patients

Pathogens ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 839
Author(s):  
Tzu-Chuan Ho ◽  
Chin-Chuan Chang ◽  
Hung-Pin Chan ◽  
Ying-Fong Huang ◽  
Yi-Ming Arthur Chen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Fdg Pet ◽  
Standardized Uptake Value ◽  
Fdg Uptake ◽  
Asymptomatic Patients ◽  
Positron Emission ◽  
Pet Ct ◽  
18F Fdg ◽  
Maximal Standardized Uptake Value ◽  
Fdg Pet Ct

During the coronavirus disease 2019 (COVID-19) pandemic, several case studies demonstrated that many asymptomatic patients with COVID-19 underwent fluorine-18 fluorodeoxyglucose ([18F]FDG) positron emission tomography/computed tomography (PET/CT) examination for various indications. However, there is a lack of literature to characterize the pattern of [18F]FDG PET/CT imaging on asymptomatic COVID-19 patients. Therefore, a systematic review to analyze the pulmonary findings of [18F]FDG PET/CT on asymptomatic COVID-19 patients was conducted. This systematic review was performed under the guidelines of PRISMA. PubMed, Medline, and Web of Science were used to search for articles for this review. Articles with the key words: “asymptomatic”, “COVID-19”, “[18F]FDG PET/CT”, and “nuclear medicine” were searched for from 1 January 2020 to 20 May 2021. Thirty asymptomatic patients with COVID-19 were included in the eighteen articles. These patients had a mean age of 62.25 ± 14.85 years (male: 67.71 ± 12.00; female: 56.79 ± 15.81). [18F]FDG-avid lung lesions were found in 93.33% (28/30) of total patients. The major lesion was [18F]FDG-avid multiple ground-glass opacities (GGOs) in the peripheral or subpleural region in bilateral lungs, followed by the consolidation. The intensity of [18F]FDG uptake in multiple GGOs was 5.605 ± 2.914 (range from 2 to 12) for maximal standardized uptake value (SUVmax). [18F]FDG-avid thoracic lymph nodes (LN) were observed in 40% (12/40) of the patients. They mostly appeared in both mediastinal and hilar regions with an SUVmax of 5.8 ± 2.93 (range from 2.5 to 9.6). The [18F]FDG uptake was observed in multiple GGOs, as well as in the mediastinal and hilar LNs. These are common patterns in PET/CT of asymptomatic patients with COVID-19.

scholarly journals [18F]FDG-PET/CT Radiomics for Prediction of Bone Marrow Involvement in Mantle Cell Lymphoma: A Retrospective Study in 97 Patients

Cancers ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1138 ◽  
Author(s):  
Marius E. Mayerhoefer ◽  
Christopher C. Riedl ◽  
Anita Kumar ◽  
Ahmet Dogan ◽  
Peter Gibbs ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Fdg Pet ◽  
Cell Lymphoma ◽  
Bone Marrow Involvement ◽  
Laboratory Data ◽  
Texture Features ◽  
Pet Ct ◽  
Mantle Cell ◽  
18F Fdg ◽  
Fdg Pet Ct

Biopsy is the standard for assessment of bone marrow involvement in mantle cell lymphoma (MCL). We investigated whether [18F]FDG-PET radiomic texture features can improve prediction of bone marrow involvement in MCL, compared to standardized uptake values (SUV), and whether combination with laboratory data improves results. Ninety-seven MCL patients were retrospectively included. SUVmax, SUVmean, SUVpeak and 16 co-occurrence matrix texture features were extracted from pelvic bones on [18F]FDG-PET/CT. A multi-layer perceptron neural network was used to compare three combinations for prediction of bone marrow involvement—the SUVs, a radiomic signature based on SUVs and texture features, and the radiomic signature combined with laboratory parameters. This step was repeated using two cut-off values for relative bone marrow involvement: REL > 5% (>5% of red/cellular bone marrow); and REL > 10%. Biopsy demonstrated bone marrow involvement in 67/97 patients (69.1%). SUVs, the radiomic signature, and the radiomic signature with laboratory data showed AUCs of up to 0.66, 0.73, and 0.81 for involved vs. uninvolved bone marrow; 0.68, 0.84, and 0.84 for REL ≤ 5% vs. REL > 5%; and 0.69, 0.85, and 0.87 for REL ≤ 10% vs. REL > 10%. In conclusion, [18F]FDG-PET texture features improve SUV-based prediction of bone marrow involvement in MCL. The results may be further improved by combination with laboratory parameters.

Evaluation of bone marrow involvement in extranodal NK/T cell lymphoma by FDG-PET/CT

2014 ◽  
Vol 94 (6) ◽  
pp. 963-967 ◽  
Author(s):  
Zhiyuan Zhou ◽  
Changying Chen ◽  
Xiang Li ◽  
Zhaoming Li ◽  
Xudong Zhang ◽  
...  
Keyword(s):  
Bone Marrow ◽  
T Cell ◽  
Fdg Pet ◽  
Cell Lymphoma ◽  
Bone Marrow Involvement ◽  
T Cell Lymphoma ◽  
Pet Ct ◽  
Nk T Cell ◽  
Fdg Pet Ct

scholarly journals Immunoglobulin D-Lambda Type Multiple Myeloma Presenting with FDG-PET/CT Negative Bone Marrow Involvement

2011 ◽  
Vol 50 (14) ◽  
pp. 1483-1487 ◽  
Author(s):  
Hisanori Machida ◽  
Tsutomu Shinohara ◽  
Hiroyuki Hino ◽  
Mitsuteru Yoshida ◽  
Nobuo Hatakeyama ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Fdg Pet ◽  
Bone Marrow Involvement ◽  
Pet Ct ◽  
Immunoglobulin D ◽  
Fdg Pet Ct
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