The role of PET/CT in the evaluation of bone marrow involvement in lymphoma patients at the initial staging

Objective: Bone marrow (BM) involvement is one of the most important prognostic factors in lymphoma patients. Therefore, it is important to determine the presence of BM involvement in lymphoma patients at the time of diagnosis. Bone marrow biopsy (BMB) is still accepted as the gold standard for evaluating the marrow but it is painful and invasive. In this retrospective study, we aimed to evaluate the role of positron emission tomography combined with computed tomography (PET/CT) in evaluating the BM involvement in lymphoma patients at the initial staging. Patients and Methods: The patients who were evaluated by PET/CT and bone marrow biopsy at time of diagnosis were enrolled in the study. Results: The overall sensitivity of PET/CT in demonstrating BM involvement was 65.8%, and the specificity was 89.4%. In the subgroup analysis of 176 Hodgkin lymphoma (HL) patients, the sensitivity and specificity of the PET/CT were 81% and 84% respectively. Negative predictive value was 98%. In 201 diffuse large B cell lymphoma (DLBCL) patients, the sensitivity and specificity of the test were 91.3% and 94.3%, respectively. Negative predictive value was 98.8%. Conclusion: PET/CT is an accurate and complementary modality with high specificity and sensitivity in detecting BM infiltration in HL and DLBCL patients.