Detection of bone marrow involvement in newly diagnosed post-transplant lymphoproliferative disorder: ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography versus bone marrow biopsy

Abstract

Detecting bone marrow involvement (BMI) in lymphoma is important as it adversely affects stage. Bone marrow biopsy (BMB) remains the standard to detect BMI but is prone to sampling error. We retrospectively investigated whether ¹⁸F-fluorodeoxyglucose positron emission tomography with computed tomography (¹⁸F-FDG-PET/CT) could identify BMI in patients with post-transplant lymphoproliferative disorder (PTLD) with sufficient accuracy in comparison with staging BMB. Twenty-five patients diagnosed with PTLD who underwent ¹⁸F-FDG-PET/CT and BMB within one month were evaluated. Based on our criteria, six patients (24%) were considered positive for BMI on ¹⁸F-FDG-PET/CT compared to one by BMB. Although we cannot completely exclude false positive results on ¹⁸F-FDG-PET/CT, our data indicate a significantly higher sensitivity of ¹⁸F-FDG-PET/CT compared to BMB (100% vs 17%) but similar specificity. These data confirm the high diagnostic performance of ¹⁸F-FDG-PET/CT for detecting BMI, but prospective studies are needed to determine whether ¹⁸F-FDG-PET/CT could indeed replace staging BMB in PTLD.

Keywords:

• Bone marrow biopsy
• FDG-PET/CT
• post-transplant lymphoproliferative disorder
• PTLD
• transplantation

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article at http://dx.doi.org/10.3109/10428194.2016.1140162.