Skip to main content
SpringerLink
Log in

Diagnosis of Bone Marrow Involvement in Pediatric Lymphoma Patients: FDG PET/CT Versus Bone Marrow Biopsy

  • Chapter
  • First Online:
Pediatric Cancer, Volume 4

Part of the book series: Pediatric Cancer ((PECA,volume 4))

  • 1612 Accesses

Abstract

Bone marrow infiltration (BMI) is common in patients with Hodgkin’s disease (HD) and non Hodgkin’s lymphoma (NHL), often indicates poor prognosis. Accurate assessment of BMI is critical for staging and selection of proper therapeutic options in lymphoma patients. Up to now, bone marrow biopsy (BMB) is an integral part of initial work-up in these patients, although it has a high false negative rate. In recent years, FDG PET/CT has established as a highly accurate imaging tool in the assessment of Hodgkin’s disease and non-Hodgkin’s lymphoma. Multiple studies have found that FDG PET/CT in the initial diagnosis work-up detects more bone marrow involvement in lymphoma patients thus are more sensitive and more accurate than bilateral bone marrow biopsy performed at the iliac crest. At the same time, it has been shown that BMB performed based on findings of FDG PET/CT significantly decreased false negative findings and improved accuracy of BMB. In this review, we discuss the value of FDG PET/CT in identifying BMI and in guiding BMB in the initial evaluation of pediatric lymphoma patients.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Allen-Auerbach M, de Vos S, Czernin J (2008) The impact of fluorodeoxyglucose-positron emission tomography in primary staging and patient management in lymphoma patients. Radiol Clin N Am 46:199–211

    Article  PubMed  Google Scholar 

  • Campbell JK, Matthews JP, Seymour JF, Wolf MM, Juneja SK, Australasian Leukaemia Lymphoma G (2003) Optimum trephine length in the assessment of bone marrow involvement in patients with diffuse large cell lymphoma. Ann Oncol 14:273–276

    Article  PubMed  CAS  Google Scholar 

  • Cheng G, Chen W, Chamroonrat W, Torigian DA, Zhuang H, Alavi A (2011) Biopsy versus FDG PET/CT in the initial evaluation of bone marrow involvement in pediatric lymphoma patients. Eur J Nucl Med Mol Imaging 38:1469–1476

    Article  PubMed  Google Scholar 

  • Cheng G, Alavi A, Zhuang H (2012) Clinical application of FDG PET/CT in pediatric lymphoma patients. PET Clin 7:47–56

    Article  Google Scholar 

  • Depas G, De Barsy C, Jerusalem G, Hoyoux C, Dresse MF, Fassotte MF, Paquet N, Foidart J, Rigo P, Hustinx R (2005) 18F-FDG PET in children with lymphomas. Eur J Nucl Med Mol Imaging 32:31–38

    Article  PubMed  Google Scholar 

  • Fuster D, Chiang S, Andreadis C, Guan L, Zhuang H, Schuster S, Alavi A (2006) Can [18F]fluorodeoxyglucose positron emission tomography imaging complement biopsy results from the iliac crest for the detection of bone marrow involvement in patients with malignant lymphoma? Nucl Med Commun 27:11–15

    Article  PubMed  Google Scholar 

  • Gemmel F, Eshuis SA, van Vollenhoven F, Gemmel P (2012) Osteoblastic healing response: discordant PET/CT findings. Eur J Nucl Med Mol Imaging 39:184–185

    Article  PubMed  Google Scholar 

  • Juneja SK, Wolf MM, Cooper IA (1990) Value of bilateral bone marrow biopsy specimens in non-Hodgkin’s lymphoma. J Clin Pathol 43:630–632

    Article  PubMed  CAS  Google Scholar 

  • Kabickova E, Sumerauer D, Cumlivska E, Drahokoupilova E, Nekolna M, Chanova M, Hladikova M, Kodet R, Belohlavek O (2006) Comparison of 18F-FDG-PET and standard procedures for the pretreatment staging of children and adolescents with Hodgkin’s disease. Eur J Nucl Med Mol Imaging 33:1025–1031

    Article  PubMed  Google Scholar 

  • Klaeser B, Wiskirchen J, Wartenberg J, Weitzel T, Schmid RA, Mueller MD, Krause T (2010) PET/CT-guided biopsies of metabolically active bone lesions: applications and clinical impact. Eur J Nucl Med Mol Imaging 37:2027–2036

    Article  PubMed  Google Scholar 

  • Levis A, Pietrasanta D, Godio L, Vitolo U, Ciravegna G, Di Vito F, Gavarotti P, Guglielmelli T, Orsucci L, Raviolo E et al (2004) A large-scale study of bone marrow involvement in patients with Hodgkin’s lymphoma. Clin Lymphoma 5:50–55

    Article  PubMed  Google Scholar 

  • Menon NC, Buchanan JG (1979) Bilateral trephine bone marrow biopsies in Hodgkin’s and non-Hodgkin’s lymphoma. Pathology 11:53–57

    Article  PubMed  CAS  Google Scholar 

  • Moid F, DePalma L (2005) Comparison of relative value of bone marrow aspirates and bone marrow trephine biopsies in the diagnosis of solid tumor metastasis and Hodgkin lymphoma: institutional experience and literature review. Arch Pathol Lab Med 129:497–501

    PubMed  Google Scholar 

  • Moog F, Bangerter M, Kotzerke J, Guhlmann A, Frickhofen N, Reske SN (1998) 18-F-fluorodeoxyglucose-positron emission tomography as a new approach to detect lymphomatous bone marrow. J Clin Oncol 16:603–609

    PubMed  CAS  Google Scholar 

  • Moulin-Romsee G, Hindié E, Cuenca X, Brice P, Decaudin D, Bénamor M, Brière J, Anitei M, Filmont J-E, Sibon D et al (2010) 18F-FDG PET/CT bone/bone marrow findings in Hodgkin’s lymphoma may circumvent the use of bone marrow trephine biopsy at diagnosis staging. Eur J Nucl Med Mol Imaging 37:1095–1105

    Article  PubMed  Google Scholar 

  • Muslimani AA, Farag HL, Francis S, Spiro TP, Chaudhry AA, Chan VC, Taylor HC, Daw HA (2008) The utility of 18-F-fluorodeoxyglucose positron emission tomography in evaluation of bone marrow involvement by non-Hodgkin lymphoma. Am J Clin Oncol 31:409–412

    Article  PubMed  Google Scholar 

  • Pakos EE, Fotopoulos AD, Ioannidis JPA (2005) 18F-FDG PET for evaluation of bone marrow infiltration in staging of lymphoma: a meta-analysis. J Nucl Med 46:958–963

    PubMed  Google Scholar 

  • Pelosi E, Penna D, Deandreis D, Chiappella A, Skanjeti A, Vitolo U, Bisi G (2008a) FDG-PET in the detection of bone marrow disease in Hodgkin’s disease and aggressive non-Hodgkin’s lymphoma and its impact on clinical management. Q J Nucl Med Mol Imaging 52:9–16

    PubMed  CAS  Google Scholar 

  • Pelosi E, Pregno P, Penna D, Deandreis D, Chiappella A, Limerutti G, Vitolo U, Mancini M, Bisi G, Gallo E (2008b) Role of whole-body [18F] fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) and conventional techniques in the staging of patients with Hodgkin and aggressive non Hodgkin lymphoma. Radiol Med 113:578–590

    Article  PubMed  CAS  Google Scholar 

  • Pelosi E, Penna D, Douroukas A, Bello M, Amati A, Arena V, Passera R, Bisi G (2011) Bone marrow disease detection with FDG-PET/CT and bone marrow biopsy during the staging of malignant lymphoma: results from a large multicentre study. Q J Nucl Med Mol Imaging 55:469–475

    PubMed  CAS  Google Scholar 

  • Purz S, Mauz-Korholz C, Korholz D, Hasenclever D, Krausse A, Sorge I, Ruschke K, Stiefel M, Amthauer H, Schober O et al (2011) [18F]Fluorodeoxyglucose Positron Emission Tomography for detection of bone marrow involvement in children and adolescents With Hodgkin’s lymphoma. J Clin Oncol 29:3523–3528

    Article  PubMed  Google Scholar 

  • Quereux G, Frot AS, Brocard A, Leux C, Renaut J-J, Dreno B (2009) Routine bone marrow biopsy in the initial evaluation of primary cutaneous B-cell lymphoma does not appear justified. Eur J Dermatol 19:216–220

    PubMed  Google Scholar 

  • Ribrag V, Vanel D, Leboulleux S, Lumbroso J, Couanet D, Bonniaud G, Auperin A, Masson F, Bosq J, Edeline V et al (2008) Prospective study of bone marrow infiltration in aggressive lymphoma by three independent methods: whole-body MRI, PET/CT and bone marrow biopsy. Eur J Radiol 66:325–331

    Article  PubMed  Google Scholar 

  • Salaun PY, Gastinne T, Bodet-Milin C, Campion L, Cambefort P, Moreau A, Le Gouill S, Berthou C, Moreau P, Kraeber-Bodere F (2009) Analysis of 18F-FDG PET diffuse bone marrow uptake and splenic uptake in staging of Hodgkin’s lymphoma: a reflection of disease infiltration or just inflammation? Eur J Nucl Med Mol Imaging 36:1813–1821

    Article  PubMed  Google Scholar 

  • Schaefer NG, Strobel K, Taverna C, Hany TF (2007a) Bone involvement in patients with lymphoma: the role of FDG-PET/CT. Eur J Nucl Med Mol Imaging 34:60–67

    Article  PubMed  Google Scholar 

  • Schaefer NG, Taverna C, Strobel K, Wastl C, Kurrer M, Hany TF (2007b) Hodgkin disease: diagnostic value of FDG PET/CT after first-line therapy–is biopsy of FDG-avid lesions still needed? Radiology 244:257–262

    Article  PubMed  Google Scholar 

  • Subramanian R, Basu D, Badhe B, Dutta TK (2007) Role of bone marrow trephine biopsy in the diagnosis of marrow involvement in Hodgkin’s disease. Indian J Pathol Microbiol 50:640–643

    PubMed  Google Scholar 

  • Tatli S, Gerbaudo VH, Mamede M, Tuncali K, Shyn PB, Silverman SG (2010) Abdominal masses sampled at PET/CT-guided percutaneous biopsy: initial experience with registration of prior PET/CT images. Radiology 256:305–311

    Article  PubMed  Google Scholar 

  • Wang J, Weiss LM, Chang KL, Slovak ML, Gaal K, Forman SJ, Arber DA (2002) Diagnostic utility of bilateral bone marrow examination: significance of morphologic and ancillary technique study in malignancy. Cancer 94:1522–1531

    Article  PubMed  Google Scholar 

  • Weiss C, Nour S, Lewin J (2008) MR-guided biopsy: a review of current techniques and applications. J Magn Reson Imaging 27:311–325

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Philadelphia VA Medical Center and Hospital of the University of Pennsylvania, Philadelphia, PA, 19104, USA

    Gang Cheng

Authors
  1. Gang Cheng
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gang Cheng .

Editor information

Editors and Affiliations

  1. , Kean University, Room 213, Library building, Morris Avenue 1000, Union, 07083, New Jersey, USA

    M.A. Hayat

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer Science+Business Media Dordrecht

About this chapter

Cite this chapter

Cheng, G. (2013). Diagnosis of Bone Marrow Involvement in Pediatric Lymphoma Patients: FDG PET/CT Versus Bone Marrow Biopsy. In: Hayat, M. (eds) Pediatric Cancer, Volume 4. Pediatric Cancer, vol 4. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-6591-7_16

Download citation

Publish with us

Policies and ethics

Search

Navigation