The Value Of ¹⁸F-FDG PET/CT In Bone Marrow Involvement Of Non-Hodgkin Lymphoma

PART ONE: The value of ¹⁸F-FDG PET/CT in the diagnosis of bone marrow involvement of non-Hodgkin LymphomaObjective To evaluate the value of ¹⁸F-FDG PET/CT imaging in the diagnosis of bone marrow involvement in non-Hodgkin Lymphoma.Methods From May 2013 to December 2016,101 patients with non-Hodgkin Lymphoma were retrospectively studied.All patients were evaluated with ¹⁸F-FDG PET/CT and bone marrow biopsy in one month.Bone marrow biopsy is the gold standard for diagnosis of bone marrow involvement.Bone SUVmax is greater than liver SUVmax or bone SUVmax ?2.5 as PET/CT diagnostic criteria for positive bone marrow involvement.The diagnostic efficiencies of ¹⁸F-FDG PET/CT using different criteria in detecting bone marrow involvement were calculated and compared.101 patients with non-Hodgkin's lymphoma were classified into invasive lymphoma group and indolent lymphoma group.The diagnostic efficacies of PET/CT imaging for different group were calculated and compared.Results The sensitivities,specificities and accuracies using different diagnostic criteria of ¹⁸F-FDG PET/CT in the diagnosis of non-Hodgkin lymphoma bone marrow involvement were 89.66%,88.89%,89.10% and 93.10%,84.72%,87.13%.There was a good relevance between ¹⁸F-FDG PET/CT and the bone marrow biopsy results?Kappa>0.7,P<0.05?.There was no significant difference between these two results using different diagnostic criteria.The accuracies of PET/CT diagnosis of invasive NHL and indolent NHL were 96.10%?74/79?and 66.67%?16/22?,and the diagnostic accuracy of invasive NHL in bone marrow involvement was higher than that of indolent NHL?X2=7.78,P=0.012?.Conclusion ¹⁸F-FDG PET/CT has a high value in the diagnosis of non-Hodgkin lymphoma bone marrow involvement.The difference between the results using different diagnostic criteria of ¹⁸F-FDG PET/CT in the diagnosis of non-Hodgkin lymphoma bone marrow involvement was not statistically significant.The value of ¹⁸F-FDG PET/CT in the diagnosis of invasive non-Hodgkin Lymphoma bone marrow involvement is higher than that of indolent non-Hodgkin lymphoma.PART TWO: The effect of ¹⁸F-FDG PET/CT on clinical staging and prognosis by the diagnosis of non-Hodgkin lymphoma bone marrow involvementObjective To evaluate the effect of ¹⁸F-FDG PET/CT on clinical staging and prognosis by the diagnosis of non-Hodgkin lymphoma bone marrow involvement.Methods From May 2013 to December 2016,101 patients with non-Hodgkin Lymphoma were retrospectively studied.All patients were evaluated with ¹⁸F-FDG PET/CT and bone marrow biopsy in one month.The diagnostic results of PET/CT or bone marrow biopsy were used as the diagnostic criteria for non-Hodgkin lymphoma bone marrow involvement and the changes of staging were compared.PET/CT diagnostic criteria for positive bone marrow involvement was Bone SUVmax greater than liver SUVmax.The patients with positive results of PET/CT and bone marrow biopsy were classified into the true positive group.The patients with negative results of PET/CT and bone marrow biopsy were classified into the true negative group.Kaplan-Meier survival analysis was performed on these two groups of patients.Results When the diagnostic results of PET/CT were used as the diagnostic criteria for non-Hodgkin lymphoma bone marrow involvement,there were 19 cases whose stages were up-regulated.When the bone marrow biopsy results were used as the diagnostic criteria for non-Hodgkin lymphoma bone marrow involvement,there were 17 cases whose stages were up-regulated.The stagings of 21 cases were finally staged up.The survival time of the patients in the true negative group was longer than that of the true positive group.The difference in survival time between these two groups was statistically significant?P<0.05?.Conclusion The using of ¹⁸F-FDG PET/CT for the diagnosis of non-Hodgkin lymphoma bone marrow involvement can correct the clinical staging and is important for improving the prognosis of patients.