FDG PET/CT for Initial Staging of Diffuse Large B-Cell Lymphoma: Is Diffuse Bone Marrow Uptake a Reflection of Disease Involvement?
|Nathalie Keromnes1*, Pierre-Yves Le Roux1, Adrian Tempescul2, Ronan Abgral1, Philippe Robin1, Naëlle Lombion2, Solène Querellou1, Xavier Palard1, Christian Berthou2 and Pierre-Yves Salaün1|
|1Department of Nuclear Medicine, University Hospital of Brest, EA 3878 (GETBO) IFR 148, France|
|2Department of Haematology, University Hospital of Brest, France|
|Corresponding Author :||Nathalie Keromnes, MD
Department of Nuclear Medicine, University Hospital of Brest
Boulevard Tanguy Prigent, 29609 Brest cedex, France
Tel: +33 298223327
Fax: +33 298223964
E-mail: [email protected][email protected]
|Received: September 15, 2015 Accepted: January 20, 2016 Published: January 27, 2016|
|Citation: Keromnes N, Roux PYL, Tempescul A, Abgral R, Robin P, et al. (2016) FDG PET/CT for Initial Staging of Diffuse Large B-Cell Lymphoma: Is Diffuse Bone Marrow Uptake a Reflection of Disease Involvement? J Bone Res 4:164.|
|Copyright: © 2016 Keromnes N, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
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Objectives: Bone marrow assessment is a diagnostic challenge in staging diffuse large B-cell lymphoma (DLBCL). Diffuse bone marrow uptake (BMU) can be observed on FDG PET/CT performed for initial staging of DLBCL, but remains difficult to analyze. The aim of this study was to evaluate the meaning of this diffuse BMU, and especially to assess its correlation with bone marrow involvement (BMI).
Methods: Patients who underwent FDG PET/CT for initial staging of DLBCL were analyzed. Diffuse BMU was assessed using a visual qualitative analysis according to liver uptake (grade 1=below liver uptake, 2=equal to liver uptake, 3=above liver uptake), and a semi-quantitative analysis, by measurement of maximum standardized uptake value (SUV) in the sacral promontory. We compared the BMU with BMI, parameters of disease extension and inflammatory markers.
Results: 86 patients (median age 59, range: 19-91, 54 men, 32 women) were included. BMU grade was 1, 2 and 3 in 45, 28 and 13 cases respectively. Bone marrow was considered involved in 13 patients. No statistical correlation was found between diffuse BMU and BMI, using qualitative (p=0.594) or semi-quantitative method (p=0.116). Diffuse BMU visual grading was correlated with inflammatory markers: biological systemic symptoms (p=0.003), CRP (p=0.002) and fibrinogen (p=0.020).
Conclusions: Our study suggests that a diffuse BMU seen on FDG PET/CT at initial staging of DLBCL is not representative of bone marrow involvement, but can be due to inflammatory changes.