PET-CT scan can be a reliable alternative to bone marrow Biopsy? Comparison of PET CT scan and marrow biopsy finding in diagnosed cases of lymphoma for staging

Abstract

Objectives: To determine the diagnostic accuracy of 18F-labeled fluoro-2-deoxyglucose (18FDG) positron emission tomography/ computed tomography (18FDG-PET/CT) scan for identifying bone marrow involvement in diagnosed patients with lymphoma keeping bone marrow biopsy (BMB) as gold standard. Study Design: cross-sectional study. Setting: Department of Radiology, Armed Forces Institute of Radiological Imaging (AFIRI), Rawalpindi from April 26, 2021 to October 25, 2021. Materials & Methods: A total of 128 cases of lymphoma of age 20-85 years and both genders were included. Patients who had taken treatment for lymphoma or were using bone marrow-stimulant factors or drugs before undergoing PET/CT scanning were excluded. PET/CT imaging was done at AFIRI 6 HD True point PET/CT 1 hour after intravenous injection of 0.2 mCi/kg 18FDG. PET acquisition was performed for 4 minutes per bed position for seven to eight bed positions. Bone marrow was classified into three types based on signal intensity and localization by FDG uptake on PT/CT as diffuse involvement, focal involvement, and normal bone marrow. Findings from 18FDG PET/CT were compared with BMB results for determining the diagnostic accuracy of abdominal FDG PET-CT. Results: Overall sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of 18FDG-PET/CT scan for identifying bone marrow involvement in diagnosed patients with lymphoma keeping BMB as gold standard was 95.45%, 93.55%, 94.03%, 95.08%, and 94.53%, respectively. Conclusion: This study concluded that the diagnostic accuracy of 18FDG-PET/CT scan for identifying bone marrow involvement in diagnosed patients with lymphoma is very high.