Detection performance and prognostic value of initial bone marrow involvement in diffuse large B-cell lymphoma: a single centre 18 F-FDG PET/CT and bone marrow biopsy evaluation study.

Autor:	Doma A; Department of Nuclear Medicine, Institute of Oncology Ljubljana, Ljubljana, Slovenia.; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia., Zevnik K; Department of Nuclear Medicine, Institute of Oncology Ljubljana, Ljubljana, Slovenia.; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia., Studen A; Experimental Particle Physics Department, Jožef Stefan Institute, Ljubljana, Slovenia.; Faculty of Mathematics and Physics, University of Ljubljana, Ljubljana, Slovenia., Prevodnik VK; Department of Cytopathology, Institute of Oncology Ljubljana, Ljubljana, Slovenia.; Faculty of Medicine, University of Maribor, Maribor, Slovenia., Gasljevic G; Faculty of Medicine, University of Maribor, Maribor, Slovenia.; Department of Pathology, Institute of Oncology Ljubljana, Ljubljana, Slovenia., Novakovic BJ; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.; Division of Medical Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
Jazyk:	angličtina
Zdroj:	Radiology and oncology [Radiol Oncol] 2024 Feb 21; Vol. 58 (1), pp. 15-22. Date of Electronic Publication: 2024 Feb 21 (Print Publication: 2024).
DOI:	10.2478/raon-2024-0004
Abstrakt:	Background: Detection of bone marrow involvement (BMI) in diffuse large B-cell lymphoma (DLBCL) typically relies on invasive bone marrow biopsy (BMB) that faces procedure limitations, while 18 F-FDG PET/CT imaging offers a noninvasive alternative. The present study assesses the performance of 18 F-FDG PET/CT in DLBCL BMI detection, its agreement with BMB, and the impact of BMI on survival outcomes. Patients and Methods: This retrospective study analyzes baseline 18 F-FDG PET/CT and BMB findings in145 stage II-IV DLBCL patients, evaluating both performance of the two diagnostic procedures and the impact of BMI on survival. Results: DLBCL BMI was detected in 38 patients (26.2%) using PET/CT and in 18 patients (12.4%) using BMB. Concordant results were seen in 79.3% of patients, with 20.7% showing discordant results. Combining PET/CT and BMB data, we identified 29.7% of patients with BMI. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of PET/CT for detecting DLBCL BMI were 88.4%, 100%, 100%, 95.3%, and 96.5%, respectively, while BMB showed lower sensitivity (41.9%) and NPV (46.8%). The median overall survival (OS) was not reached in any gender subgroup, with 5-year OS rates of 82% (total), 84% (female), and 80% (male) (p = 0.461), while different International Prognostic Index (IPI) groups exhibited varied 5-year OS rates: 94% for low risk (LR), 91% for low-intermediate risk (LIR), 84% for high-intermediate risk (HIR), and 65% for high risk (HR) (p = 0.0027). Bone marrow involvement did not impact OS significantly (p = 0.979). Conclusions: 18 F-FDG PET/CT demonstrated superior diagnostic accuracy compared to BMB. While other studies reported poorer overall and BMI 5-year OS in DLBCL, our findings demonstrated favourable survival data. (© 2024 Andrej Doma et al., published by Sciendo.)
Databáze:	MEDLINE
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