J Nucl Med. 2008; 49 (Supplement 1):134P
General Clinical Specialties: General Practice-OncologyLymphoma |
Is routine bone marrow biopsy necessary in staging patients with Hodgkin disease in the PET era?
Gerard Moulin-Romsee1,
Elif Hindie1,
Xavier Cuenca2,
Pauline Brice2,
Didier Decaudin3,
Georges Baillet1,
Jean-Emanuel Filmont1,
Myriam Benamor4,
Christian Gisselbrecht2 and
Jean-Luc Moretti1
1 Nuclear Medicine;
2 Haematology-Oncology, CHU St. Louis, Paris, France;
3 Haematology;
4 Nuclear Medicine, Institut Curie, Paris, France
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Objectives: Initial adequate staging of Hodgkin lymphoma (HL) is mandatory for tailored treatment, including bone marrow biopsy (BMB). Whereas pretreatment PET(CT) is currently not formally mandatory, it has been strongly recommended to facilitate interpretation of equivocal post therapy PET/CT scans and provide useful information regarding delineation of involved field radiation therapy. The aim of this retrospective study was therefore to assess the place of BMB in initial staging of HL patients without bone or bone marrow involvement detected on PET/CT.
Methods: All data from 48 patients with newly diagnosed HL and who had both PET/CT and BMB before start of treatment were collected.
Results: 4/48 patients had lymphomatous involvement on BMB. All those 4 patients were also positive on PET/CT scan. In 9 additional patients, PET/CT scan showed multiple foci suggestive of bone/ bone marrow involvement. Further confirmation of these lesions was obtained by MRI in 3 patients and on prestating CT in 1. BMI findings on PET/CT led to upstaging of 6 patients with initial stage II or III; 3 others were already stage IV.
Conclusions: PET/CT appears better than BMB to detect bone/bone marrow involvement. We therefore conclude that, in patient with pre-treatment negative PET/CT, BMB is probably not justified.
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BMB findings versus PET findings
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