Abstract
The aim of this retrospective study was to evaluate the characteristics of increased bone marrow uptake of 18F-FDG in patients with leukemia who underwent whole-body 18F-FDG PET/CT. The 18F-FDG PET/CT images of 9 patients with histologically proven leukemia were reviewed. The accumulation of 18F-FDG in the bone marrow was evaluated, and was compared with histological subtype, clinical course, and hematological findings. Nine patients (4 males, 5 females; age range, 5–58 years) had increased bone marrow uptake of 18F-FDG, including 6 patients with acute lymphoblastic leukemia, 1 with acute myeloid leukemia, 1 with chronic myeloid leukemia, and 1 with mature B cell neoplasm. Bone marrow uptake was generally diffuse but focal or inhomogeneous uptake was common, especially in the upper and lower extremities. Patients with increased bone marrow uptake of 18F-FDG commonly complained of fever and bone pain. No correlations between 18F-FDG uptake and peripheral blood findings were observed. Patients with leukemia may have increased bone marrow uptake of 18F-FDG on PET/CT, possibly reflecting leukemic cell activity. Leukemia can be included in the differential diagnosis when increased bone marrow uptake of 18F-FDG is observed.
Highlights
Leukemia is a hematological malignancy characterized by malignant cells that exist mainly in the bone marrow (BM) and peripheral blood
We previously reported a case of acute lymphoblastic leukemia associated with diffuse homogeneous BM uptake of 18F-FDG (Su et al 2013), indicating that some patients with leukemia who have tumor cells in the BM aspirate have increased BM uptake of 18F-FDG on positron emission tomography (PET)/computed tomography (CT)
After the exclusion of 24 patients, the imaging findings of the remaining 9 patients were analyzed (4 males, 5 females; age range, 5–58 years). 18FFDG PET/CT was performed for pre-therapeutic staging in 5 patients, for re-staging in 2 patients, and to investigate prolonged unexplained pyrexia in 2 patients who were subsequently diagnosed with leukemia
Summary
Leukemia is a hematological malignancy characterized by malignant cells that exist mainly in the bone marrow (BM) and peripheral blood. 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) or 18F-FDG PET/computed tomography (CT) is widely used for the diagnosis, staging, and response assessment of various types of Increased BM uptake of 18F-FDG is sometimes observed after chemotherapy, after administration of granulocyte colony-stimulating factor, in patients with malignant lymphoma, and in patients with multiple bone metastases. The frequency of increased BM uptake of 18FFDG in patients with leukemia, and associations between uptake characteristics and laboratory findings, are currently unknown
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