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Titel: 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
VerfasserIn: 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
Sprache: Englisch
Titel: European Journal of Nuclear Medicine and Molecular Imaging
Verlag/Plattform: Springer Nature
Erscheinungsjahr: 2021
Freie Schlagwörter: FDG PET/CT
Lymphoma
Aggressive B-cell lymphoma
Bone marrow biopsy
Diagnostic performance
DDC-Sachgruppe: 610 Medizin, Gesundheit
Dokumenttyp: Journalartikel / Zeitschriftenartikel
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 der Erstveröffentlichung: 10.1007/s00259-021-05348-6
Link zu diesem Datensatz: 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
Datum des Eintrags: 22-Jun-2021
Bezeichnung des in Beziehung stehenden Objekts: Supplementary information
In Beziehung stehendes Objekt: https://static-content.springer.com/esm/art%3A10.1007%2Fs00259-021-05348-6/MediaObjects/259_2021_5348_MOESM1_ESM.docx
Fakultät: M - Medizinische Fakultät
Fachrichtung: M - Innere Medizin
Professur: M - Prof. Dr. Stephan Stilgenbauer
Sammlung:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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