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Lymphoma and Pets
Better Method Found to Determine Bone Marrow Involvement in DLBCL
Researchers have discovered a better way of determining whether patients with diffuse large B-cell lymphoma (DLBCL) have bone marrow involvement – a development that should lead to better decisions about frontline treatment.
Reporting in the August issue of the Journal of Nuclear Medicine , researchers led by Loius Berthet, M.D., carried out a retrospective study of 133 patients diagnosed with DLBCL. All patients underwent both a bone marrow biopsy and a whole-body 18F-FDG PET/CT scan.
In our study, we showed that in diffuse large B-cell lymphoma, 18F-FDG PET/CT has better diagnostic performance than bone marrow biopsy to detect bone marrow involvement and provides a better prognostic stratification. While bone marrow biopsy is considered the gold standard to evaluate bone marrow involvement by high-grade lymphomas, 18F-FDG PET/CT is in fact the best method to evaluate extension of the disease, as well as avoid invasive procedures.
Compared to bone marrow biopsy, 18FDG PET/CT was:
- More sensitive (94 percent vs. 24 percent)
- Showed a higher negative predictive value (98 percent vs. 80 percent)
- More accurate (98 percent vs. 81 percent)
A total of 26 patients were found to have positive 18F-FDG PET/CT results but negative biopsy results. Eleven of them were restaged as stage IV by PET/CT. This effectively changed their treatment plans.
Our findings add to the literature to prove the significance of 18F-FDG PET/CT in cancer evaluation and to democratize this imaging method. Molecular imaging is the best method to adapt targeted therapies to each patient. The emergence of PET/MRI and novel radiotracers predicts an exciting new future for our field.