Assessment of bone marrow status in diffuse B-cell large cell lymphoma: PET/CT capabilities

Abstract

The aim of this work was to present the results of a retrospective study of 35 patients with morphologically diagnosed diffuse B-cell large cell lymphoma with bone marrow damage from 22 to 82 years old, median 63 years. There were 27 men and 8 women. After histological confirmation, all patients performed positron emission tomography combined with computed tomography with 18F-fluorodeoxyglucose (FDG PET/CT) followed by bone marrow trepanobiopsy. Specific bone marrow lesions were detected in 100% of cases with PET/CT and in 68.6% of cases with trepanobiopsy. Diffuse bone marrow damage was detected in 24 (68.6%) cases, focal – in 10 (28.6%) patients and in 1 (2.8%) patient – a mixed variant. The data obtained indicate the predominance of diffuse damage to the bone marrow. The statistical analysis established the value of the standardized maximum absorption coefficient of FDG SUVmax for bone marrow damage equal more than 3.58. Sensitivity was at 90% and a specificity was at 92%. The sensitivity of the PET/CT method is higher with focal lesions of the bone marrow than with diffuse. SUVmax was 10.26 ± 1.67 and 2.86 ± 0.09, respectively. The differences between them are significant (p < 0.0001). PET/CT is a non-invasive method of metabolic imaging allows you to assess the condition of the bone marrow and other extranodal symptoms of the disease at the stage of diagnosis, treatment and follow-up. It can replace the traditional method of bone marrow biopsy with diffuse B-cell large cell lymphoma.