Determining Malignant Involvement in Bone Marrow with Diffuse 18F-FDG Uptake Showed on PET/CT

• 作 者: Wu Hu-bing Wang Quan-shi Wang Min-fang Xu Bing Zhang Jun-Yi Li Hong-sheng
• 机 构: NanFang PET Center,Nanfang Hospital,Southern Medical University,Guangzhou,510515,China
• 出 处: The 1st Sino-American Conference on Nuclear Medicine(首届中美核医学
• 发表日期: 2011年12期
• 关键词: 18F-FDG diffuse bone marrow uptake positron emission tomography malignant involv

　　Objective: How to determine the malignant involvement (MI) in bone marrow with 18F-FDG diffuse uptake showed on PET/CT is difficult.We herein retrospectively analyzed 63 patients to establish a diagnostic criteria.Methods: A total of 63 patients with diffuse BMU were retrospectively studied.BMU level was visually evaluated and graded according to liver and brain uptake (1=below and corresponding to liver uptake, 2=above liver uptake, 3=corresponding to brain uptake).Sacral standardized uptake values (SUVmax) were used to evaluate the uptake intensity.Bone marrow biopsy and imaging follow-up were used as a golden standard.Results: Thirty eight patients were found to have MI and 25 were of benign origin uptakes (BOU).MI was confirmed in 95.4%, 53.8% and 35.7% of patients with grade 3, 2 and 1 uptake,respectively (x2 =18.656, P<0.001).Associated focal BMUs and/or focal osteolytic lesions were found in 42.1% of patients with MI and in 4.0% of those with BOU(x2 =11.11, P=0.001).Two criterias (Criteria 1 : BMU level larger than grade 2.Criteria 2: Grade 3 uptake of BM or lower uptake but with associated focal lesions) were established to diagnosis MI.Sensitivity of Criteria 1 and Criteria 2 were 73.6%, 76.3 respectively (x2 =0.07, P=1.00) and the specificity were 72.0%,96.0%, respectively (x2 =5.357, P=0.049).Conclusions: In patients with diffuse BMU, grade 3 uptake of BM or lower uptake but with associated focal BMUs and/or focal osteolytic lesions were strong indications of MI.