Utility and prognostic value of PET/CT, bone marrow biopsy and aspirate for detection of bone marrow involvement in diffuse large B-cell lymphoma

Abstract

Objective: This study aimed to determine the value of bone marrow biopsy (BMB) , bone marrow aspiration (BMA) , and positron emission tomography combined with computed tomography (PET/CT) in bone marrow (BM) involvement and prognosis evaluation in diffuse large B-cell lymphoma (DLBCL) . Methods: The clinical data of patients with DLBCL who underwent PET/CT, BMB, and BMA of the iliac crest were retrospectively analyzed in Peking Union Medical College Hospital from January 2015 to November 2017. The BM involvement on PET/CT was defined as the ratio of maximal standardized uptake values of iliac crest BM to liver parenchyma intensity ≥1. Results: A total of 76 patients without liver involvement were enrolled, there were 32 males, and the median age was 53 (17-79) . Moreover, 16 patients (21.1%) had BM involvement on PET/CT, 12 (15.8%) had positive BMB, and 13 (17.1%) had positive BMA. Excellent correlation between BMA and BMB (κ=0.943) was found, including good correlation between PET/CT and BMB/BMA (κ=0.763 and 0.776, respectively) . After a median follow-up of 52 (0-82) months, BM involvement by BMB (P=0.037) and BMA (P=0.007) were poor prognostic factors for overall survival, positive PET/CT had no significant effect on prognosis (P>0.05) . Conclusion: PET/CT, BMB, and BMA are effective methods to detect BM involvement with great concordance. However, iliac crest BMB and BMA showed superior performance in prognosis evaluation.