Assessing Bone Marrow Involvement in DLBCL with 18F-FDG PET/CT

A study found that positron emission tomography with 18F-Fludeoxyglucose (FDG) integrated with computed tomography (18F-FDG PET/CT) is a robust detector of bone marrow involvement (BMI) in newly diagnosed diffuse large B-cell lymphoma (DLBCL). The results appeared in The Medical Journal of Malaysia.

“The role of 18F-FDG PET/CT has been explored as a non-invasive method for detecting BMI in newly diagnosed DLBCL. Due to limited evidence, this method has not been adopted as a mainstream investigation for BMI,” the researchers wrote.

In this study, researchers assessed 21 patients with DLBCL at Hospital Pulau Pinang in Malaysia who all underwent 18F-FDG PET/CT and bone marrow biopsy (BMB). The diagnostic capacity of 18F-FDG PET/CT was discerned using the BMB histopathological evaluation as the reference standard.

According to the results, seven patients demonstrated BMI on PET/CT. The researchers observed that 14 scans were negative for BMI and consistent with BMB. Overall, the sensitivity and specificity of 18F-FDG PET/CT scans for detecting BMI was 100% and 77.8%, respectively.

The researchers concluded that 18F-FDG PET/CT “is excellent for ruling-out the presence of BMI. A negative 18F-FDG PET/CT scan for BMI can preclude the need for BMB in certain cases.”

However, they added that although 18F-FDG PET/CT can accurately detect BMI in multifocal pattern of infiltration, “it cannot fully replace BMB, which is still considered as the gold standard for evaluating BMI in DLBCL.”