THE ACCURACY OF 18F-FDG PET/CT IN PREDICTING BONE MARROW INFILTRATION IN NON-HODGKIN’S AND HODGKIN’S LYMPHOMA AMONG SAUDI POPULATION

Abstract

Aim: The first aim is to assess the diagnostic performance of FDG-PET/CT in predicting BMI in patients diagnosed with NHL and HL. The second aim is to compare three reference sites (mediastinal blood pool, liver, and brain), that are used for FDG-PET/CT quantitative assessment, and determine which one is the most accurate in detecting BMI in lymphoma patients. Material and Methods: This is a retrospective study of 90 patients subjected to both BMB and FDG-PET/CT assessment at a single institution in Saudi Arabia between March 2015 to March 2020. The data was collected from patient medical records, histological and imaging reports. Both FDG-PET/CT visual and quantitative results were determined and compared to BMB as the standard assessment of disease involvement in the bone marrow. Results: The NHL group had the highest FDG-PET/CT sensitivity (85.50%), specificity (75.61%), and accuracy (77.55%), compared to HL group with 60%, 66.7%, and 65.9%, respectively. Both groups had high negative predictive values (92–97%) and lower positive predictive values (20–41%). The heterogeneously increased uptake patter was more precise in demonstrating BMI. The highest mean SUV ratio was found to be 1.66 ± 1.1 for BM/BP ratio, followed 1.25 ± 0.9 for BM/liver ratio, and 0.31 ± 0.2 for BM/brain ratio. The ROC curve showed that BM/Brain ratio has the highest accuracy among NHL and HL groups. Conclusion: FDG-PET/CT scan is accurate and complementary to the standard assessment of disease involvement in bone marrow, BMB. The scan adds value to BMB in the initial staging of lymphomas.