Journal
DIAGNOSTICS
Volume 12, Issue 1, Pages -Publisher
MDPI
DOI: 10.3390/diagnostics12010222
Keywords
diffuse large B cell lymphoma; FDG; PET; CT; radiomics
Categories
Funding
- National Research Foundation of Korea [NRF-2019R1G1A1009158]
- Basic Science Research Program through the National Research Foundation of Korea [NRF-2018R1D1A1A02086383]
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This study compared the results of FDG PET/CT and BMBx in DLBCL patients and found that they are complementary in the evaluation of bone involvement.
Whether FDG PET/CT can replace bone marrow biopsy (BMBx) is undecided in patients with diffuse large B cell lymphoma (DLBCL). We compared the visual PET findings and PET radiomic features, with BMBx results. A total of 328 patients were included; 269 (82%) were PET-negative and 59 (18%) were PET-positive for bone lesions on visual assessment. A fair degree of agreement was present between PET and BMBx findings (kappa = 0.362, p < 0.001). Bone involvement on PET/CT lead to stage IV in 12 patients, despite no other evidence of extranodal lesion. Of 35 discordant PET-positive and BMBx-negative cases, 22 (63%) had discrete bone uptake on PET/CT. A total of 144 patients were eligible for radiomic analysis, and two grey-level zone-length matrix derived parameters obtained from the iliac crests showed a trend for higher values in the BMBx-positive group compared to the BMBx-negative group (mean 436.6 +/- 449.0 versus 227.2 +/- 137.8, unadjusted p = 0.037 for high grey-level zone emphasis; mean 308.8 +/- 394.4 versus 135.7 +/- 97.2, unadjusted p = 0.048 for short-zone high grey-level emphasis), but statistical significance was not found after multiple comparison correction. Visual FDG PET/CT assessment and BMBx results were discordant in 17% of patients with newly diagnosed DLBCL, and the two tests are complementary in the evaluation of bone involvement.
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