Can18F-FDG PET/CT replace the bone marrow biopsy in patients with non-Hodgkin lymphoma: A systematic review
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JAWAHER KHALID ABDULHALEEM ALMAIMANI
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Abstract
Key Messages:
1- 18F-FDG PET/CT can replace or used as complementary for BMB with NHL and subtypes lymphoma.
2- 18F-FDG PET/CT predicts the BMI better than BMB with NHL paediatric patients.
Abstract
‘Introduction’
In non-Hodgkin lymphoma (NHL) patients identifying bone marrow involvement (BMI) is important for the disease management. Bone marrow biopsy (BMB) is the standard method used to evaluate BMI, although is invasive. 18F-Fluorodeoxyglucose positron emission tomography–computed tomography (18F-FDG PET-CT) is an imaging technique used to determine the BMI non-invasively.
‘Objectives’
This systematic review aimed to evaluating the diagnostic performance of 18F-FDG PET/CT in detecting the BMI compared to the BMB for NHL and subtypes of lymphoma patients.
‘Methods’
The PubMed, Scopus, and the Web of Science databases were systematically searched. The overall sensitivities, specificities, negative and positive predictive values calculated for the patients reported in all the articles.
‘Results’
A total of 27 studies, with 4014 NHL patients were included for the analysis. The overall sensitivity, specificity for 18F-FDG PET/CT in diagnosis of BMI in NHL patients were 70.27%, 73.61%, respectively, whereas they were 57.70%, 69.60% for BMB. In contrast, the BMB represent higher sensitivity and specificity 79% and 48% than 18F-FDG PET/CT 37% and 40% for MCL patients, respectively.
‘Discussion’
The diagnostic performance of 18F-FDG PET/CT endorsed higher accuracy than BMB in diagnosis of BMI for NHL, aggressive NHL, DLBCL, and PTCL. However, the BMB diagnostic performance for indolent NHL, MCL, BL, FL, PMBCL was better than 18F-FDG PET/CT to assess the BMI.
‘Conclusion’
The 18F-FDG PET/CT can replace the BMB or used as a complementary method to BMB for BMI detection. The 18F-FDG PET/CT could be used as complementary to BMB with paediatric lymphoma patients.
Keywords: Bone marrow, FDG PET/CT, Non-Hodgkin lymphoma, biopsy, systematic review.