E-ISSN: 1308-5263
Performance of Positron Emission Tomography-Computed Tomography and Bone Marrow Biopsy in Detecting Bone Marrow Infiltration in Lymphoma Cases [Turk J Hematol]
Turk J Hematol. 2020; 37(4): 220-225 | DOI: 10.4274/tjh.galenos.2020.2019.0361  

Performance of Positron Emission Tomography-Computed Tomography and Bone Marrow Biopsy in Detecting Bone Marrow Infiltration in Lymphoma Cases

Mahmut Büyükşimşek1, İrem Kolsuz2, Abdullah Evren Yetişir1, Mert Tohumcuoğlu1, Ali Oğul3, Cem Mirili4, Semra Paydaş1, İsa Burak Güney5
1Çukurova University Faculty of Medicine, Department of Medical Oncology, Adana, Turkey
2Çukurova University Faculty of Medicine, Department of Internal Medicine, Adana, Turkey
3Adana Health Practice and Research Center, Department of Medical Oncology, Adana, Turkey
4Atatürk University Faculty of Medicine, Department of Medical Oncology, Erzurum, Turkey
5Çukurova University Faculty of Medicine, Department of Nuclear Medicine, Adana, Turkey

Objective: Bone marrow infiltration (BMI) affects the stage diagnosis, and treatment of lymphoma. We aimed to evaluate the performance of bone marrow biopsy (BMB) and positron emission tomographycomputed tomography (PET/CT) in detecting BMI in lymphoma patients.
Materials and Methods: A total of 269 non-Hodgkin’s lymphoma (NHL) and 110 Hodgkin’s lymphoma (HL) patients were evaluated retrospectively. Sensitivity, negative predictive value (NPV), and accuracy were calculated for PET/CT and BMB in detecting BMI.
Results: Sensitivity, NPV, and accuracy for PET/CT in detecting BMI in NHL cases were 65%, 78%, and 84.4%, respectively, while they were 55%, 73.4%, and 79.9% for BMB. PET/CT performance for diffuse large B-cell lymphoma and follicular lymphoma was better than that of BMB, whereas the performance of BMB was better for mantlecell lymphoma, Burkitt’s lymphoma, and primary mediastinal B-cell lymphoma. Sensitivity, NPV, and accuracy for PET/CT in HL cases were 91.3%, 97.75%, and 98.18%, respectively, while they were 56.52%, 89.69%, and 90.91% for BMB. Due to BMB, 43 (15.9%) patients in the NHL group and 2 (1.8%) patients in the HL group were protected from downstaging.
Conclusion: Although their results vary according to NHL subtypes, PET/CT and BMB are complementary methods in determining BMI. In HL, PET/CT is an important diagnostic tool for detecting BMI, and BMB is not necessary in a significant proportion of cases.

Keywords: Lymphoma, Bone marrow infiltration, PET/CT, Bone marrow biopsy


Lenfoma Olgularında Kemik İliği İnfiltrasyonunu Saptamada Pozitron Emisyon Tomografi- Bilgisayarlı Tomografi ve Kemik İliği Biyopsisinin Performansı

Mahmut Büyükşimşek1, İrem Kolsuz2, Abdullah Evren Yetişir1, Mert Tohumcuoğlu1, Ali Oğul3, Cem Mirili4, Semra Paydaş1, İsa Burak Güney5
1Çukurova University Faculty of Medicine, Department of Medical Oncology, Adana,Turkey
2Çukurova University Faculty of Medicine, Department of Internal Medicine, Adana, Turkey
3Adana Health Practice and Research Center, Department of Medical Oncology, Adana, Turkey
4Ataturk University Faculty of Medicine, Department of Medical Oncology, Erzurum, Turkey
5Çukurova University Faculty of Medicine, Department of Nuclear Medicine, Adana, Turkey

Amaç: Kemik iliği infiltrasyonu (Kİİ), lenfoma evresini, sağkalımı ve tedaviyi etkiler. Lenfoma hastalarında Kİİ’yi saptamada kemik iliği biyopsisi (KİB) ve pozitron emisyon tomografi-bilgisayarlı tomografinin (PET/BT) performanslarını değerlendirmek istedik.
Gereç ve Yöntem: İki yüz altmış dokuz non-Hodgkin lenfoma (NHL) ve 110 hodgkin lenfoma (HL) hastası retrospektif olarak değerlendirildi. Kİİ’yi saptamada PET/BT ve KİB için duyarlılık, negatif prediktif değer (NPD) ve doğruluk hesaplandı.
Bulgular: NHL olgularında Kİİ’yi saptamada PET/BT için duyarlılık, NPD ve doğruluk sırasıyla %65, %78 ve %84,4 iken KİB için %55, %73,4 ve %79,9 idi. Diffüz büyük B-hücreli lenfoma ve folliküler lenfoma için PET/BT performansı KİB’den daha iyi iken; mantle-cell lenfoma, Burkitt’s lenfoma ve primer mediastinal B-hücreli lenfomada KİB performansı daha iyiydi. HL olgularında PET/BT için duyarlılık, NPD ve doğruluk sırasıyla %91,3, %97,75 ve %98,18 iken KİB için %56,52, %89,69 ve %90,91 idi. KİB yapılması ile NHL grubunda 43 (%15,9), HL grubunda ise 2 (%1,8) olgunun düşük evrelenmesinden korunmuş olundu.
Sonuç: Kİİ’yi saptamada NHL alt tiplerine göre değişmekle birlikte PET/BT ve KİB birbirini tamamlayıcı yöntemlerdir. HL’de ise Kİİ’yi saptamak için PET/BT önemli bir tanı aracıdır ve KİB olguların önemli kısmında gerekli değildir.

Anahtar Kelimeler: Lenfoma, Kemik iliği infiltrasyonu, PET/BT, Kemik iliği biyopsisi


Mahmut Büyükşimşek, İrem Kolsuz, Abdullah Evren Yetişir, Mert Tohumcuoğlu, Ali Oğul, Cem Mirili, Semra Paydaş, İsa Burak Güney. Performance of Positron Emission Tomography-Computed Tomography and Bone Marrow Biopsy in Detecting Bone Marrow Infiltration in Lymphoma Cases. Turk J Hematol. 2020; 37(4): 220-225

Corresponding Author: Mahmut Büyükşimşek, Türkiye


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