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Analysis of 18F-FDG PET diffuse bone marrow uptake and splenic uptake in staging of Hodgkins lymphoma
European Journal of Nuclear Medicine & Molecular Imaging, 06/08/09

Salaun PY et al. - In a study to evaluate the significance of 18F-FDG diffuse bone marrow uptake (BMU) and splenic uptake (SU) in initial staging of Hodgkin’s lymphoma (HL), the study demonstrates that diffuse BMU at initial staging of HL could be due to bone marrow involvement but more likely to bone marrow inflammatory change and that diffuse SU in contrast is probably more associated with disease involvement than with inflammatory change.

Methods

106 pts underwent 18F-FDG PET/CT for initial staging of HL.
BMU level was assessed visually according to liver uptake (1=below liver uptake, 2=corresponding to liver uptake, 3=above liver uptake) and semi-quantitatively using the maximum standardized uptake value (SUVmax) measured in the sacral area.
SU was assessed visually according to liver uptake (1=below liver uptake, 2=corresponding to liver uptake, 3=above liver uptake).
These data were compared with the pt’s characteristics including sex, age, Ann Arbor staging, bulky disease (tumour burden >10 cm), presence of B symptoms, bone foci on PET (n=106), bone marrow involvement (BMI) on biopsy (n=75), leukocyte count (n=74), lactic dehydrogenase (LDH) (n=87), C-reactive protein (CRP) (n=83), and fibrinogen (n=60).

Results

Multivariate analysis found an independent correlation between BMU visual grading and CRP level.
For semi-quantitative BMU evaluation, multivariate analysis found an independent correlation between sacral SUVs and CRP level and Ann Arbor stage.
No BMI was found in pts who presented with SUVmax below 3.4.
For splenic evaluation, multivariate analysis found an independent correlation between SU and splenic foci.
No statistical link was found between SU and inflammatory markers.

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