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The relationship between bone marrow involvement on 18F-FDG PET/CT and bone marrow biopsy in patients with multiple myeloma and other plasma cell neoplasms
Author(s) -
Kiflom S. Gebreslassie,
Fatima Bassa,
Zivanai C. Chapanduka,
James Warwick
Publication year - 2022
Publication title -
south african journal of oncology/south afri‪can journal of oncology
Language(s) - English
Resource type - Journals
eISSN - 2523-0646
pISSN - 2518-8704
DOI - 10.4102/sajo.v6i0.197
Subject(s) - medicine , bone marrow , multiple myeloma , conventional pci , biopsy , standardized uptake value , nuclear medicine , positron emission tomography , radiology , plasma cell myeloma , lymphoma , pathology , myocardial infarction
Background: Bone marrow biopsy (BMB) plays a crucial role in the diagnosis and assessment of treatment response in patients with multiple myeloma (MM). 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) has been shown to be a complimentary measure of marrow involvement in patients with Hodgkin and diffuse large B cell lymphomas. However, only limited information is available on its relationship with BMB in MM.Aim: To assess the association between bone marrow involvement on 18F-FDG PET/CT, and BMB in patients with MM and other plasma cell neoplasms.Setting: Cape Town, South Africa.Methods: Hundred and three patients undergoing 18F-FDG PET/CT and BMB were included. Plasma cell infiltration (PCI) on BMB was compared for three visual patterns of 18F-FDG bone marrow uptake (irregular, diffuse less than or equal to the liver and diffuse greater than liver).Results: Eighty-four patients had diffuse bone marrow uptake. Of these, 25/84 had uptake greater than liver, all having PCI ≥ 60% and a median value of 85%. Of the 84 patients, the 59 patients with uptake less than or equal to liver had PCI 10% in 57.6% (34/59), and ≥ 10% in 42.4% (25/59) with a median value of 8%. Nineteen patients had irregular bone marrow uptake. Of these, 4/19 (21.1%) had PCI of 10% and 15/19 (78.9%) had PCI ≥ 10%, with the median value of 23%. The median percentage of PCI across the three described patterns of FDG uptake was significantly different (p = 0.0001).Conclusion: 18F-fluorodeoxyglucose positron emission tomography/computed tomography might avoid the need of repeat BMB in most of the patients with diffuse and irregular patterns of 18F-FDG uptake.

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