PET studies are used on a regular basis in the initial staging of lymphoma patients-pretreatment-and assess response to treatment and prognosis. BM involvement is synonymous of a stage IV and is associated with a worse short and long-term prognosis. Concordant BMu and BM involvement confirmed by a biopsy has been reported to correlate with worse outcomes.
The utility of FDG PET-CT in evaluating BM involvement has also been explored by other authors with variable results as to its benefit. Because FDG PET-CTâs are performed routinely now in the pretherapy staging of most lymphoma patients, extracting noninvasively additional information in regards to bone marrow status would be very valuable. This is in the context of knowing that not all patients are clinically eligible to undergo a BMb, that selecting eligible patients is not always a straightforward exercise, and without overlooking the fact that a BMb has a small adverse event rate (ranging from pain, bleeding, infections), as well as an additional cost of the procedure and pathology review. Additionally sampling occasionally may not be adequate for pathology interpretation and a repeat procedure becomes challenging. Uncovering quantitative and qualitative parameters to elucidate the etiology of bone marrow uptake may help the radiologist and oncologist. BMu is frequently encountered on pretherapy scans and almost always seen in post-treatment scans due to reactive changes. Pretherapy, it can be associated with disease involvement, however occasionally uptake will be related to benign etiologies (anemia, stimulation, a hypercellular marrow â¦ etc)
Djekidel M, Pre-Treatment FDG PET Bone Marrow (BM) Uptake and Disease Involvement. Can Semiquantitative Measures Discriminate Between A Normal, Hypercellular or Infiltrated Bone Marrow?
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Last date updated on July, 2014