Research Article
Pre-Treatment FDG PET Bone Marrow (BM) Uptake and Disease Involvement. Can Semiquantitative Measures Discriminate Between A Normal, Hypercellular or Infiltrated Bone Marrow?
Ahmed R1Xiaopan Yao2Fourzali Y3Djekidel M4*1PGY4: Nuclear Medicine, Yale University School of Medicine, USA
2Department of Diagnostic Radiology, Yale University School of Medicine, USA
3Associate Director, Biostatistics Shared Resource; Yale Cancer Center, USA
4Assistant Professor, Section of Medical Oncology; Yale School of Medicine, USA
- Corresponding Author:
- Mehdi Djekidel
Assistant Professor in Diagnostic Radiology
Fellowship Director for Nuclear Radiology
Yale University School of Medicine, Yale Cancer Center, USA
Tel: 203 200 5180
Fax: 203 200 5170
E-mail: [email protected]
Received Date: March 15, 2013; Accepted Date: April 28, 2013; Published Date: April 30, 2013
Citation: Ahmed R, Yao X, Fourzali Y, Djekidel M (2013) Pre-Treatment FDG PET Bone Marrow (BM) Uptake and Disease Involvement. Can Semiquantitative Measures Discriminate Between A Normal, Hypercellular or Infiltrated Bone Marrow? J Bone Marrow Res 1:115. doi: 10.4172/2329-8820.1000115
Copyright: © 2013 Ahmed R, 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.
Abstract
PET studies are used on a regular basis to stage lymphoma patients pretreatment. Bone marrow uptake (BMu) can be associated with disease involvement, however occasionally uptake is related to benign etiologies (anemia, stimulation, a hypercellular marrow etc…). Uncovering quantitative and qualitative parameters to elucidate the etiology of (BMu) may help the radiologist and oncologist in cases where a BM biopsy (BMb) cannot be performed or interpreted by the pathologist or is unavailable. We looked retrospectively at a group of consecutive lymphoma patients (pts) who had an initial staging PET scan. Out of 121 patients, 36 had a (BMb) report available for review. We attempted to evaluate whether semi quantitative parameters – maximum standardized uptake value (SUVm); Average SUV (SUVav); SUVm/Mediastinal blood pool (MBP) ratio - could discriminate between different bone marrow patterns (normal, hypercellular, positive). We also looked at the type of BMu (none; mild; prominent) and pattern (patchy; diffuse; focal). The average age of our patient population was 52.19. 66.66% were males (24/36). Most of our patient’s had a normal BMb. 25 % (9/36) had a positive BM. In the BM positive group, no pts had patchy uptake and 2 pts were found to have no appreciable uptake. In the BM normal group 71.5 % (15/21) had either mild or prominent uptake and only 28.5% had no uptake. None had focal uptake and 90% of pts had diffuse uptake. The majority of whole cohort had a SUVm> 2.5: 90 % of BM normal; 100% of hypercellular BM and 88.88% of the BM positive group and an SUVm/MBP>2.5: 52.4%; 66.66% and 55.5% respectively. Using a Chi-square test BM Pathology level was overall significantly different across the BMu patterns (p=0.0192). Analysis looking at BM positive versus BM negative groups, shows BM pattern is no longer a significant variable to predict BM pathology (p=0.168). Subsequently, the odds ratio of having only positive BM pathology based on focal vs. patchy pattern is not significant. Conclusion: No qualitative or semi quantitative parameters were found to be statistically significantly associated with BM pathology. Further exploration in a larger cohort is necessary.
