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 Lymphoma 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 hdl:20.500.11880/31401 http://dx.doi.org/10.22028/D291-34218 |
ISSN: | 1619-7089 1619-7070 |
Date of registration: | 22-Jun-2021 |
Description of the related object: | Supplementary information |
Related object: | https://static-content.springer.com/esm/art%3A10.1007%2Fs00259-021-05348-6/MediaObjects/259_2021_5348_MOESM1_ESM.docx |
Faculty: | M - Medizinische Fakultät |
Department: | M - Innere Medizin |
Professorship: | M - Prof. Dr. Stephan Stilgenbauer |
Collections: | SciDok - Der Wissenschaftsserver der Universität des Saarlandes |
Files for this record:
File | Description | Size | Format | |
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Kaddu-Mulindwa2021_Article_FDGPETCTToDetectBoneMarrowInvo.pdf | 1,28 MB | Adobe PDF | View/Open |
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