KEY TAKEAWAYS
- The study aimed to investigate the efficacy of 18F-FDG PET/CT in detecting BMI in DLBCL, assess its agreement with BMB, and evaluate the impact of BMI on survival outcomes.
- Researchers noticed superior diagnostic accuracy of 18F-FDG PET/CT over BMB in DLBCL, contradicting prior reports of poorer overall and BMI 5-year OS, revealing more favorable survival outcomes.
Detection of bone marrow involvement (BMI) in diffuse large B-cell lymphoma (DLBCL) traditionally relies on invasive bone marrow biopsy (BMB), which poses procedural limitations. In contrast, 18F-FDG PET/CT imaging presents a noninvasive alternative for assessing BMI.
Andrej Doma and the team aimed to evaluate the performance of 18F-FDG PET/CT in detecting BMI in DLBCL, examine its agreement with BMB, and explore the impact of BMI on survival outcomes.
They performed an inclusive analysis of baseline 18F-FDG PET/CT and BMB findings in 145 stage II-IV DLBCL patients. The study assessed the diagnostic performance of these two procedures and examined the influence of BMI on survival outcomes.
About 26.2% of DLBCL patients (38 individuals) exhibited BMI when assessed with 18F-FDG PET/CT, compared to 12.4% (18 patients) using BMB. Concordant results were observed in 79.3% of cases, with 20.7% displaying discordant outcomes. Integrating PET/CT and BMB data, 29.7% of patients were identified with BMI.
The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of PET/CT for detecting DLBCL BMI were 88.4%, 100%, 100%, 95.3%, and 96.5%, respectively, while BMB showed lower sensitivity (41.9%) and NPV (46.8%).
The median overall survival (OS) was not reached in any gender subgroup, and the 5-year OS rates were 82% (total), 84% (female), and 80% (male) (P = 0.461). Varied 5-year OS rates were observed among different International Prognostic Index (IPI) groups: 94% for low risk (LR), 91% for low-intermediate risk (LIR), 84% for high-intermediate risk (HIR), and 65% for high-risk (HR) (P = 0.0027). Interestingly, BMI did not significantly impact OS (P = 0.979).
The study concluded that 18F-FDG PET/CT exhibited superior diagnostic accuracy compared to BMB in DLBCL. In contrast to previous studies reporting poorer overall and BMI 5-year OS, their findings revealed favorable survival outcomes, emphasizing the potential of PET/CT as a valuable tool for improved prognostication in DLBCL patients.
Source: https://pubmed.ncbi.nlm.nih.gov/38378029/
Doma A, Zevnik K, Studen A, et al. (2024). “Detection performance and prognostic value of initial bone marrow involvement in diffuse large B-cell lymphoma: a single centre 18F-FDG PET/CT and bone marrow biopsy evaluation study.” Radiol Oncol. 2024 Feb 21;58(1):15-22. doi: 10.2478/raon-2024-0004. PMID: 38378029; PMCID: PMC10878769.
