PET/CT versus bone marrow biopsy in the initial evaluation of bone marrow infiltration in various pediatric malignancies

Zapata, Claudia Patricia Montoya; Cuglievan, Branko; Zapata, Catalina M.; Olavarrieta, Raquel; Raskin, Scott; Desai, Kavita; Angulo, Guillermo De

doi:10.1002/pbc.26814

Cited by 20 publications

(24 citation statements)

References 13 publications

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“…In the present study, bone marrow SUVmax and the SUVmax-ratio were two meaningful parameters for NB patients with BMI. PET/CT has high sensitivity for assessing bone marrow infiltration in pediatric malignancies 13 , 26 . In particular, PET has improved sensitivity in detecting BMI in patients with lymphoma and may allow patients with positive BMI confirmed by PET/CT examinations to avoid undergoing invasive BMB 27 , 28 .…”

Section: Discussionmentioning

confidence: 99%

“…However, there is no clear conclusion on the significance of PET/CT for assessing the metabolism of tumor cells in the bone marrow of patients with NB. An important advantage of PET/CT over BMB is that PET/CT can assess all bone marrow sites at once and find unintended bone marrow infiltration in areas where biopsies are not usually performed 13 . The bone marrow manifests higher metabolic activity and FDG uptake when tumor cells have transferred to the bone marrow, which can guide clinical diagnosis, staging and treatment.…”

Section: Discussionmentioning

confidence: 99%

“…There are a few studies on the application of 18F-FDG PET/CT for NB 2 , 10 , 11 . However, most of these studies focused on comparing the diagnostic efficacy of 18F-FDG PET/CT and other imaging methods, such as iodine 123 metaiodobenzylguanidine (I-123 MIBG) 11 , 12 , or only evaluated the diagnostic value of 18F-FDG PET/CT for NB 13 , 14 . To the best of our knowledge, there are few studies that have assessed the prognostic significance of the metabolic parameters on PET/CT or have evaluated the correlation between semiquantitative PET/CT parameters and clinical features in patients with NB 15 , 16 .…”

Section: Introductionmentioning

confidence: 99%

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Value of pretreatment 18F-FDG PET/CT in prognosis and the reflection of tumor burden: a study in pediatric patients with newly diagnosed neuroblastoma

Man¹,

Yan²,

Li³

et al. 2021

Int. J. Med. Sci.

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Fluorine-18 fluorodeoxyglucose (18F-FDG) PET/CT has been commonly used in pediatric patients with newly diagnosed neuroblastoma (NB) for diagnosis. We retrospectively reviewed 40 pediatric patients with newly diagnosed NB who underwent 18F-FDG PET/CT. Clinicopathological factors and metabolic parameters including maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) on PET/CT were evaluated as predictive factors for progression-free survival (PFS) and overall survival (OS) by univariate and multivariate analysis. Spearman rank correlation analyses were used to estimate the correlations between clinical factors and PET findings. The mean follow-up after 18F-FDG-PET/CT was 32.9 months. During the follow-up period 15 (37.5%) patients experienced progression, and 9 (22.5%) died. MTV (P=0.001) and TLG (p=0.004) remained significant predictive factors for tumor progression, along with lactate dehydrogenase (LDH), neuron-specific enolase (NSE) and bone metastasis. Univariate analysis showed that bone metastasis, LDH (>1064 IU/L), NSE (>364.4 ug/L), MTV (>191 cm3) and TLG (>341.41 g) correlated with PFS, and LDH (>1064 IU/L), NSE (>364.4 ug/L) and MTV (>191 cm 3) correlated with OS (p<0.05). In multivariate analysis, MTV and bone metastasis were independent prognostic factors for PFS (p=0.001 and 0.023, respectively), and MTV remained the only independent prognostic factor for OS (p= 0.004). We also found that there were correlations between semiquantitative PET/CT parameters and clinical features in NB. Our results suggested that 18F-FDG PET/CT was a useful tool to predictive progression and to reflect tumor burden for patients with NB.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Value of pretreatment 18F-FDG PET/CT in prognosis and the reflection of tumor burden: a study in pediatric patients with newly diagnosed neuroblastoma

Man¹,

Yan²,

Li³

et al. 2021

Int. J. Med. Sci.

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“…Bone marrow aspiration and biopsy are the main methods for the diagnosis of multiple myeloma, lymphoma with bone marrow infiltration, and cancer with bone marrow metastasis 1 . Hemodilution of bone marrow aspirates is the main contributor to a missed diagnosis after the examination of bone marrow smears.…”

Section: Introductionmentioning

confidence: 99%

“…Bone marrow aspiration and biopsy are the main methods for the diagnosis of multiple myeloma, lymphoma with bone marrow infiltration, and cancer with bone marrow metastasis. 1 Hemodilution of bone marrow aspirates is the main contributor to a missed diagnosis after the examination of bone marrow smears. Moreover, the location of the puncture site and the degree of cancer cell dispersion also affect the rate of positive findings on bone marrow biopsy, as the growth of myeloma cells is localized, and tumor cells from lymphoma and cancer in the bone marrow are limited.…”

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confidence: 99%

Bone marrow particle enrichment analysis for the laboratory diagnosis of multiple myeloma: A case study

Zhang

2020

Clinical Laboratory Analysis

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Background Bone marrow smear and biopsy are the main methods for the diagnosis of multiple myeloma (MM), bone marrow infiltration, and metastasis in lymphoma and cancer. However, several factors, including the focal growth of tumor cells, inappropriate puncture sites, and hemodilution of bone marrow aspirates, lower the rate of target cell detection. To solve this problem, we developed a novel method—bone marrow particle enrichment analysis—and here, we describe this procedure and its use in the diagnosis of a rare case of MM. Methods An 88‐year‐old man with primary gastric gamma delta T‐cell lymphoma (γδTCL) was found to have anemia. As the cause of anemia could not be determined, hemodilution was suspected, warranting the re‐examination of the bone marrow aspirate. Re‐puncture could not be performed because of the patient's age and unwillingness to undergo this procedure. Hence, we used a novel approach to enrich bone marrow particles and isolate marrow cells, and subsequently performed morphological and flow cytometric analysis. Results Examinations performed after bone marrow particle enrichment revealed the presence of myeloma cells, and the patient was diagnosed with primary gastric γδTCL accompanied by MM. Conclusions Bone marrow particle enrichment analysis may be applied to overcome the problems caused by hemodilution of bone marrow aspirates and to improve the rate of tumor cell detection. The application of this method for the diagnosis of hematological disorders should be explored further.

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Fluorine-18-fluorodeoxyglucose (FDG) positron emission tomography (PET) computed tomography (CT) for the detection of bone, lung, and lymph node metastases in rhabdomyosarcoma

Breunis

Haveman

Vaarwerk

et al. 2021

Cochrane Database of Systematic Reviews

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Rhabdomyosarcoma (RMS) is the most common paediatric soft-tissue sarcoma and can emerge throughout the whole body. For patients with newly diagnosed RMS, prognosis for survival depends on multiple factors such as histology, tumour site, and extent of the disease. Patients with metastatic disease at diagnosis have impaired prognosis compared to those with localised disease. Appropriate staging at diagnosis therefore plays an important role in choosing the right treatment regimen for an individual patient. Fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) is a functional molecular imaging technique that uses the increased glycolysis of cancer cells to visualise both structural information and metabolic activity. 18F-FDG-PET combined with computed tomography (CT) could help to accurately stage the extent of disease in patients with newly diagnosed RMS. In this review we aimed to evaluate whether 18F-FDG-PET could replace other imaging modalities for the staging of distant metastases in RMS. Objectives To determine the diagnostic accuracy of 18F-FDG-PET/CT imaging for the detection of bone, lung, and lymph node metastases in RMS patients at first diagnosis. Search methods We searched MEDLINE in PubMed (from 1966 to 23 December 2020) and Embase in Ovid (from 1980 to 23 December 2020) for potentially relevant studies. We also checked the reference lists of relevant studies and review articles; scanned conference proceedings; and contacted the authors of included studies and other experts in the field of RMS for information about any ongoing or unpublished studies. We did not impose any language restrictions. Selection criteria We included cross-sectional studies involving patients with newly diagnosed proven RMS, either prospective or retrospective, if they reported the diagnostic accuracy of 18F-FDG-PET/CT in diagnosing lymph node involvement or bone metastases or lung metastases or a combination of these metastases. We included studies that compared the results of the 18F-FDG-PET/CT imaging with those of histology or with evaluation by a multidisciplinary tumour board as reference standard. Data collection and analysis Two review authors independently performed study selection, data extraction, and methodological quality assessement according to Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2). We analysed data for the three outcomes (nodal involvement and lung and bone metastases) separately. We used data from the 2 × 2 tables (consisting of true positives, false positives, true negatives, and false negatives) to calculate sensitivity and specificity in each study and corresponding 95% confidence intervals. We did not consider a formal meta-analysis to be relevant because of the small number of studies and substantial heterogeneity between studies. Main results Two studies met our inclusion criteria. The diagnostic accuracy of 18F-FDG-PET/CT was reported in both studies, which included a total of 36 participants. We considered both studies to be at high risk of bias for the do...

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PET/CT versus bone marrow biopsy in the initial evaluation of bone marrow infiltration in various pediatric malignancies

Cited by 20 publications

References 13 publications

Value of pretreatment 18F-FDG PET/CT in prognosis and the reflection of tumor burden: a study in pediatric patients with newly diagnosed neuroblastoma

Value of pretreatment 18F-FDG PET/CT in prognosis and the reflection of tumor burden: a study in pediatric patients with newly diagnosed neuroblastoma

Bone marrow particle enrichment analysis for the laboratory diagnosis of multiple myeloma: A case study

Fluorine-18-fluorodeoxyglucose (FDG) positron emission tomography (PET) computed tomography (CT) for the detection of bone, lung, and lymph node metastases in rhabdomyosarcoma

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