Bone Marrow Biopsy Adds Little to PET/CT Staging of Hodgkin’s

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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.

(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, MD, 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% had focal skeletal PET/CT lesions and 6% had positive BMB. Among patients assessed as having Stage I–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% and a specificity of 86%; the sensitivity and specificity for BMB results were 28% and 99%, 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–Stage IV disease of a total of 454 included patients.”

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