Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Nuclear Medicine

Aim of work:To compare between FDG PET/CT and routine iliac bone marrow biopsy (BMB) in assessment of bone marrow infiltration in Hodgkin lymphoma (HL) and aggressive non-Hodgkin lymphoma (NHL) lymphoma patient at presentation. Patients and Methods: This prospectivestudy was conducted on 138 patients (50 HL, 88 NHL). The study included 70 male and 68 female with median age of 43 years (range 20-70 years). All patients had pre therapy FDG PET/CT and BMB. Results Concordance between PET/CT and BMB was observed in 104 (75.4%) of 138 patients. Both tests were negative in 86 patients and both were reported positive in 18 patients. Among the 88 NHL, bone marrow infiltration (BMI) was detected by PET/CT in 26 (29.5%) and by BMB in 22 (25%), the concordance was detected in 64 (72.7%) patients, both tests were negative in 52 and positive in 12 patients (p 0.003). In 50 HL, BMI was detected by PET/CT in 14 (28%) and by BMB in 8 (16%), the concordance between PET/CT and BMB was detected in 40 (80%) patients, both tests were negative in 34 patients and positive in 6 patients (p 0.001). The overall results revealed a border line significant higher sensitivity for FDG PET/CT (73.9%) compared to BMB (62.5%) (p 0.046). FDG PET-CT provides upstaging in 8.6% of the enclosed patients. In HL group, PET/CT showed significantly higher sensitivity compared to BMB being 87.5% versus 50% (p 0.02).While For NHL group, comparable results of sensitivity were seen in PET/CT and BMB being 66.7%, versus 68.8% (p<0.1). Conclusion: FDG PET/CT seemed to be a promising alternative tool to BMB in assessment of BMI at initial assessment of HL & NHL lymphoma

Issued also as CD