Bone Marrow Biopsy Adds Little to PET/CT Staging of Hodgkin's
Absence of positive bone marrow biopsy for patients with PET/CT-assessed stage I, II disease
WEDNESDAY, Nov. 14 (HealthDay News) -- For patients with treatment-naive Hodgkin's lymphoma (HL) staged using [18F]fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT), routine bone marrow biopsy (BMB) has little or no therapeutic consequence, according to research published online Nov. 13 in the Journal of Clinical Oncology.
Tarec Chistoffer El-Galaly, M.D., of Aarhus University Hospital in Denmark, and colleagues conducted a retrospective study involving 454 patients with newly diagnosed HL to determine whether BMB adds useful information to PET/CT staging.
Of the patients, 18 percent had focal skeletal PET/CT lesions and 6 percent had positive BMB. Among patients assessed as having stage I to II disease by PET/CT staging, the researchers found that none were positive for BMB. Five patients assessed as being stage III before BMB were upstaged by BMB, but none of the patients were allocated to a different treatment based on the results of BMB. For identification of positive and negative BMBs, focal skeletal PET/CT lesions had a sensitivity of 85 percent and a specificity of 86 percent; the sensitivity and specificity for BMB results were 28 and 99 percent, respectively.
"To the best of our knowledge, this is the largest study to date examining the value of BMB in patients with HL who are undergoing PET/CT staging," the authors write. "The added diagnostic value from routine BMB was minimal, and positive BMB findings implied upstaging in only five patients from stage III to stage IV disease of a total of 454 included patients."