Bone Marrow infiltration in Pre-therapy assessment of pediatric lymphoma patients; FDG PET/CT versus BMB.

Objectives: To compare between FDG PET/CT and routine iliac BMB in initial assessment of bone marrow infiltration in pediatric lymphoma patients.

Methods: 140 pediatric patients with pathologically proven lymphoma [113 Hodgkin’s disease (HD), 27 non- Hodgkin’s lymphoma (NHL)] were enrolled in this study. All patients had pre therapy FDG PET/CT and BMB within a period not exceeding two weeks apart. Clinico-pathological and other radiological data were extracted from registration file.

Results: Among the 113 HD patients FDG PET/CT revealed positive BM involvement in 27 patients, 2 of which proved to be falsely positive with negative BMB & regional MRI results. On the other hand BMB was positive for BM infiltration in 8 patients all of which were also positive in PET/CT. In NHL group FDG PET/CT revealed positive BM involvement in 14 patients, only 6 of them have positive BMB. None of patient has positive BMI by BMB & negative FDG PET/CT for BM infiltration in both groups. The overall results revealed significant higher sensitivity for FDG PET/CT (100%) compared to BMB (35.9%) (P<0.05). FDG PET-CT provides upstaging in 17.9 % of the enclosed patients.

Conclusion: FDG PET/CT seemed to be a promising alternative tool to BMB in assessment of BMI at initial assessment of HD & NHL pediatric lymphoma. Its high sensitivity & upstaging impact stand behind. Research Support: No support