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Italian Multicenter Study on Accuracy of 18F-FDG PET/CT in Assessing Bone Marrow Involvement in Pediatric Hodgkin Lymphoma
Authors:Angelina Cistaro  Laura Cassalia  Cinzia Ferrara  Natale Quartuccio  Laura Evangelista  Maurizio Bianchi  Franca Fagioli  Gianni Bisi  Sergio Baldari  Alessandro Zanella  Marta Pillon  Pietro Zucchetta  Marta Burei  Alessandra Sala  Luca Guerra  Priscilla Guglielmo  Roberta Burnelli  Stefano Panareo  Giuseppe Rubini
Affiliation:1. Positron Emission Tomography Centre, IRMET S.p.A., Affidea, Turin, Italy;2. PET Pediatric Study Group, Italian Association of Nuclear Medicine and Molecular Imaging, Milan, Italy;3. Nuclear Medicine Unit, Umberto I Hospital, Syracuse, Italy;4. Wolfson Molecular Imaging Centre, University of Manchester, Manchester, United Kingdom;5. Nuclear Medicine and Molecular Imaging Unit, Istituto Oncologico Veneto, Istituto di Ricovero e Cura a Carattere Scientifico, Padua, Italy;6. Pediatric Onco-Hematology and Stem Cell Transplant Division, City of Health and Science, Regina Margherita Children''s Hospital, Turin, Italy;7. Italian Association Pediatric Oncology and Hematology, Turin, Italy;8. Division of Nuclear Medicine, Azienda Ospedaliera Universitaria, Città della Salute e della Scienza, Turin, Italy;9. Nuclear Medicine Unit, Department of Biomedical Sciences and Morphologic and Functional Images, University of Messina, Messina, Italy;10. Nuclear Medicine Service, Department of Medicine, University Hospital, Padua, Italy;11. Department of Child and Woman Health, Oncology Hematology Division, University-Hospital of Padua, Padua, Italy;12. Maria Letizia Verga Center, MBBM Foundation – San Gerardo Hospital, Monza, Italy;13. Nuclear Medicine Unit, San Gerardo Hospital, Monza, Italy;14. Oncoematologia Pediatrica, Azienda Ospedaliera Universitaria, Ospedale Sant''Anna, Ferrara, Italy;15. Unit of Nuclear Medicine, Department of Diagnostic Imaging, S. Anna University Hospital, Ferrara, Italy;16. Nuclear Medicine Unit, University of Bologna, Bologna, Italy;17. Nuclear Medicine Unit, Department of Diagnostic Imaging, E. O. Galliera Hospital, Genoa, Italy;18. Dipartimento di Ematologia e Oncologia, Pediatrica Istituto G. Gaslini, Genova, Italy;19. Nuclear Medicine Department and PET/CT Center, ARNAS Garibaldi-Nesima, Catania, Italy;20. Nuclear Medicine Department, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy;21. S. S. Radioterapia Pediatrica e Area Giovani, Istituto di Ricovero e Cura a Carattere Scientifico, Centro di Riferimento Oncologico Aviano, Pordenone, Italy;22. Nuclear Medicine Unit, University of Bari, Bari, Italy;23. Pediatric Hematology-Oncology Division, Department of Pediatrics, University of Bari, Bari, Italy;24. Nuclear Medicine Unit, Istituto di Ricovero e Cura a Carattere Scientifico, National Cancer Institute, Aviano, Italy
Abstract:

Introduction

The present study investigated the utility of fluorine-18 (18F) fluoro-2-deoxy-d-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in assessing bone marrow involvement (BMI) compared with bone marrow biopsy (BMB) in newly diagnosed pediatric Hodgkin lymphoma (HL).

Patients and Methods

A total of 224 pediatric patients with HL underwent 18F-FDG PET/CT at staging. BMB or follow-up imaging was used as the standard of reference for the evaluation of BMI.

Results

18F-FDG PET/CT was negative for BMI in 193 cases. Of the 193 patients, the findings for 16 were originally reported as doubtful and later interpreted as negative for BMI, with negative findings on follow-up imaging and BMB. At BMB, 1 of the 16 patients (6.25%) had BMI. Of the 193 patients, 192 (99.48%) had negative BMB findings. Thus, the 18F-FDG PET/CT findings were truly negative for 192 patients and falsely negative for 1 patient for BMI.

Conclusion

18F-FDG PET/CT showed high diagnostic performance in the evaluation of BMI in pediatric HL. Thus, BMB should be ideally reserved for patients presenting with doubtful 18F-FDG PET/CT findings for BMI.
Keywords:BMI  Bone marrow biopsy  Computed tomography  Newly diagnosed pediatric HL  Positron emission tomography
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