Preliminary Studies Of ¹⁸FDG-PETt/CT And Dwi For Evaluation Of Lymphoma Bone Marrow Infiltration

Objective:To explore the clinical value of two imaging examination methods(FDG-PET/CT,DWI) for evaluation of lymphoma bone marrow infiltration, and to compare them with the bone marrow pathological examination(bone marrow smear, bone marrow biopsy and flow cytometry analysis of bone marrow) respectively. Methods:Retrospectively analyze the bone marrow of 93 untreated patients with pathologically diagnosed lymphoma(61 patients underwent 18FDG-PET/CT examination, 32 underwent DWI examination). With bone marrow pathology results as “gold standard”, the condition and type of each subtype lymphoma bone marrow infiltration were analyzed, and the detectable rate and the effect on staging of the two imaging examination methods for evaluation of different type of lymphoma bone marrow infiltration were compared. Results:39 patients were diagnosed as bone marrow infiltration based on the bone marrow pathological examination of routine site and bone marrow pathological examination guided by PET/CT and DWI. The sensitivity, specificity, accuracy, positive and negative predictive value of PET/CT for evaluation of lymphoma bone marrow infiltrationare80.77%, 88.57%, 85.25%, 84.00%, 86.11% respectively; for DWI examination, they are 84.62%, 89.47%, 87.50%, 84.62%, 89.47% respectively. Detectable rates of the two imaging examination methods for the invasive lymphoma are 37.5%(18/48) and 38.09%(8/21) separately, and they are slightly higher than detectable rates for the inert lymphoma that are 23.08%(3/13), 27.27%(3/11).However, there is no significant difference in PET/CT and DWI(p=0.521>0.05; p=0.660>0.05). No matter it is invasive lymphoma or inert lymphoma, the detectable rate of DWI is slightly higher than that of PET/CT. There is still no significant difference in PET/CT and DWI(p=0.963>0.05; p=1.000>0.05). Conclusion:Both FDG-PET/CT and DWI have important diagnostic value for lymphoma bone marrow infiltration. Both imaging technology have equal value for the diagnostic of bone marrow infiltration. Though they cannot replace BMB, the combination of the two kinds of imaging technology can further improve the detectable rate of bone marrow infiltration.