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The Value of 18F-FDG PET/CT in Detecting Bone Marrow Involvement in Childhood Cancers

Yağci-Küpeli, Begül MD, MSc*; Koçyiğit-Deveci, Emel MD; Adamhasan, Fulya MD; Küpeli, Serhan MD, MSc§

Journal of Pediatric Hematology/Oncology: August 2019 - Volume 41 - Issue 6 - p 438–441
doi: 10.1097/MPH.0000000000001499
Original Articles

Background: The aim of this study was to assess the utility of 18F-fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in assessing bone marrow involvement (BMI) compared with bone marrow biopsy (BMB) in the initial staging of pediatric patients with non-Hodgkin lymphoma (NHL), Hodgkin lymphoma (HL), Ewing sarcoma (ES), and neuroblastoma (NB).

Procedure: A total of 94 patients (57 boys, 37 girls, median age 7 y, range 1 to 18 y) with newly diagnosed NHL, HL, ES, and NB between July 2014 and December 2017, who underwent BMB and 18F-FDG PET/CT before chemotherapy were included in this study. There were 36 patients with NHL, 27 HL, 16 ES, and 15 NB. 18F-FDG PET/CT and BMB results were reviewed and compared retrospectively.

Findings: Retrospective analysis of data from 94 pediatric patients (57 boys, 37 girls, median age 7 y, range 1 to 18 y) was performed. Of the 94 patients, 29 had BMI on 18F-FDG PET/CT. BMB was positive in 14, negative in 13, and insufficient in 2 of these 29 patients. In 65 patients negative on 18F-FDG PET/CT, BMB was also negative in 54 and insufficient in 7. For the whole group, sensitivity, specificity, and positive and negative predictive values of 18F-FDG PET/CT in detecting bone marrow metastasis at the time of diagnosis were 90.6%, 100%, 100%, and 95.4% and those of BMB were 53.1%, 87.1%, 94.4%, and 80.6%, respectively.

Conclusion: Our study demonstrates that 18F-FDG PET/CT predicts BMI better than BMB. 18F-FDG PET/CT may be used at initial staging of pediatric patients with NHL, HL, ES, and NB.

Departments of *Pediatric Hematology and Oncology

Nuclear Medicine

Pathology, Health Sciences University, Adana City Education and Research Hospital

§Department of Pediatric Oncology and Pediatric Bone Marrow Transplantation Unit, Çukurova University Faculty of Medicine, Adana, Turkey

The authors declare no conflicts of interest.

Reprints: Serhan Küpeli, MD, MSc, Department of Pediatric Oncology and Pediatric Bone Marrow Transplantation Unit, Faculty of Medicine, Çukurova University, 01330 Adana, Turkey (e-mail:

Received September 14, 2018

Accepted March 28, 2019

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