Please use this identifier to cite or link to this item: doi:10.22028/D291-34218
Title: 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
Author(s): Kaddu-Mulindwa, Dominic
Altmann, Bettina
Held, Gerhard
Angel, Stephanie
Stilgenbauer, Stephan
Thurner, Lorenz
Bewarder, Moritz
Schwier, Maren
Pfreundschuh, Michael
Löffler, Markus
Menhart, Karin
Grosse, Jirka
Ziepert, Marita
Herrmann, Ken
Dührsen, Ulrich
Hüttmann, Andreas
Barbato, Francesco
Poeschel, Viola
Hellwig, Dirk
Language: English
Title: European Journal of Nuclear Medicine and Molecular Imaging
Publisher/Platform: Springer Nature
Year of Publication: 2021
Free key words: FDG PET/CT
Aggressive B-cell lymphoma
Bone marrow biopsy
Diagnostic performance
DDC notations: 610 Medicine and health
Publikation type: Journal Article
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
DOI of the first publication: 10.1007/s00259-021-05348-6
Link to this record: urn:nbn:de:bsz:291--ds-342189
ISSN: 1619-7089
Date of registration: 22-Jun-2021
Description of the related object: Supplementary information
Related object:
Faculty: M - Medizinische Fakultät
Department: M - Innere Medizin
Professorship: M - Prof. Dr. Stephan Stilgenbauer
Collections:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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