TY - JOUR T1 - Comparison of FDG PET/CT and bone marrow biopsy results in patients with diffuse large B cell lymphoma with subgroup analysis of PET radiomics JF - Journal of Nuclear Medicine JO - J Nucl Med SP - 1686 LP - 1686 VL - 62 IS - supplement 1 AU - Hyukjin Yoon AU - Woo Hee Choi AU - Seunggyun Ha AU - Jae won Min AU - Joo Hyun O AU - Eun Chae Chun AU - Ie Ryung Yoo Y1 - 2021/05/01 UR - http://jnm.snmjournals.org/content/62/supplement_1/1686.abstract N2 - 1686Purpose: Clinically FDG PET/CT has not replaced bone marrow biopsy in the initial staging of patients with diffuse large B cell lymphoma (DLBCL). We aimed to compare the FDG PET/CT findings and results of bone marrow biopsy from iliac bones. In addition, we explored multiple PET radiomic features from the iliac bone. Methods: FDG PET/CT images from 2019 and 2018 of consecutive adult patients with newly diagnosed DLBCL and bone marrow biopsy performed within one month were included. The FDG PET/CT was centrally reviewed by visual analysis, and the findings were categorized: (1) negative for bone lesion; (2) positive for bone lesion; and (3) equivocal PET finding with intense, diffuse bone uptake or moderate but discrete bone uptake not consistent with known benign condition. PET images obtained under the same acquisition and reconstruction conditions were further assessed for radiomic analysis. Forty PET parameters, including conventional parameters and texture parameters, were extracted with LIFex software, from 3.5 to 4.0 cubic centimeter cylinder volume of interests from bilateral iliac crests. The visual PET findings for bone lesions and PET features from the iliac bones were compared to the bone marrow biopsy results. Results: A total of 104 patients were included. FDG PET/CT visual analysis and bone marrow biopsy results are described in table 1. In 8 (7.7%) patients, intense discrete FDG uptakes in the bones lead to the clinical diagnosis of bone involvement, despite negative bone marrow biopsy results. In another group of 8 patients, the bone marrow biopsy results were positive, despite the negative PET findings. For cases with equivocal PET findings, 13 of 18 (72.2%) were bone marrow biopsy negative, while 5 were bone marrow biopsy positive. Sixty-six patients underwent PET/CT exam under the same acquisition and reconstruction conditions and were eligible for texture analysis. There was no significant difference between bone marrow biopsy negative and positive patients for PET parameters, including mean SUV (1.5±0.5 vs. 1.4±0.7), skewness (0.4±0.3 vs. 0.4±0.3), or homogeneity (0.4±0.1 vs. 0.4±0.1). Conclusions: In 29 of 104 (27.9%) FDG PET/CT images of patients with DLBCL, the bone marrow biopsy and visual PET findings were discordant. In 8 patients (7.7%), bone involvement on FDG PET/CT lead to clinical stage IV diagnosis, despite negative bone marrow biopsy results. No PET parameter from the iliac bones could reliably distinguish the marrow biopsy negative and positive groups. $$table_{856CF155-AC8F-4194-82EA-538738C30828}$$ View this table: ER -