1. Loss of utility of bone marrow biopsy as a staging evaluation for Hodgkin lymphoma in the positron emission tomography-computed tomography era: a West of Scotland study.
- Author
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Hamilton R, Andrews I, McKay P, and Leach M
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Biopsy standards, Female, Humans, Male, Middle Aged, Neoplasm Staging standards, Reproducibility of Results, Scotland, Sensitivity and Specificity, Young Adult, Bone Marrow pathology, Hodgkin Disease diagnosis, Hodgkin Disease pathology, Positron-Emission Tomography, Tomography, X-Ray Computed
- Abstract
Abstract Positron emission tomography-computed tomography (PET-CT) scanning has been shown to be more sensitive than bone marrow biopsy (BMB) in detecting bone marrow involvement (BMI) in classical Hodgkin lymphoma (cHL). In this 5-year retrospective series, 93 (54%) of all new cases of cHL were staged using PET-CT and BMB. PET-CT identified focal bone marrow uptake in 17/93 (18.3%), whilst only five of these (29.4%) were confirmed by BMB. Abnormal pelvic uptake was seen on PET-CT in these five cases. The other 12 cases were missed, giving BMB a sensitivity of 29.4% and a specificity of 100%. PET-CT upstaged 9.7% of patients compared to CT alone. BMB upstaged only one patient; however, this patient was already stage IV on PET-CT. BMB did not alter clinical management in any case. Bone positivity on PET-CT appeared to correlate with anemia, raised lactate dehydrogenase (LDH) and B symptoms. BMB has little or nothing to offer staging cHL in the PET-CT era.
- Published
- 2014
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