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Assessment of bone marrow inflammation in patients with myelofibrosis: an 18F-fluorodeoxyglucose PET/CT study

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Abstract

Purpose

Myelofibrosis is a haematopoietic stem cell neoplasm characterized by bone marrow inflammation, reactive marrow fibrosis and extramedullary haematopoiesis. The aim of this study was to determine if 18F-FDG PET/CT can be used to noninvasively visualize and quantify the extent and activity of bone marrow involvement.

Methods

In 30 patients, the biodistribution of 18F-FDG was analysed by measuring the standardized uptake value in the bone marrow compartment and spleen. Imaging findings were compared with laboratory, cytogenetic and histopathological data.

Results

Retention of 18F-FDG was observed in bone marrow and spleen. Bone marrow involvement varied, ranging from mildly increased uptake in the central skeleton to extensive uptake in most parts of the skeleton. The extent of bone marrow involvement decreased over time from initial diagnosis (r s  = −0.43, p = 0.019). Metabolic activity of the bone marrow decreased as the histopathological grade of fibrosis increased (r s  = −0.37, p = 0.04). There was a significant positive correlation between the metabolic activity of the bone marrow and that of the spleen (p = 0.04).

Conclusion

18F-FDG PET/CT is as a promising technique for the quantitation of bone marrow inflammation in myelofibrosis. Our data indicate that the intensity of bone marrow 18F-FDG uptake decreases as bone marrow fibrosis increases. Further evaluation in prospective studies is required to determine the potential clinical impact and prognostic significance of PET.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany

    Thorsten Derlin & Frank M. Bengel

  2. Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Thorsten Derlin & Peter Bannas

  3. Clinic for Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Haefaa Alchalby, Ioanna Triviai & Nicolaus Kröger

  4. Department of Diagnostic and Interventional Radiology, University Medical Center Würzburg, Würzburg, Germany

    Simon Veldhoen

  5. Department of Radiology and Nuclear Medicine, Otto-von-Guericke University, Magdeburg, Germany

    Ivayla Apostolova

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  1. Thorsten Derlin
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Correspondence to Thorsten Derlin.

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Derlin, T., Alchalby, H., Bannas, P. et al. Assessment of bone marrow inflammation in patients with myelofibrosis: an 18F-fluorodeoxyglucose PET/CT study. Eur J Nucl Med Mol Imaging 42, 696–705 (2015). https://doi.org/10.1007/s00259-014-2983-4

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  • DOI: https://doi.org/10.1007/s00259-014-2983-4

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