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Hell J Nucl Med. 2017 Jan-Apr;20(1):17-25. doi: 10.1967/s002449910502. Epub 2017 Mar 20.

Prognostic value of bone marrow 18F-FDG uptake on PET/CT in lymphoma patients with negative bone marrow involvement.

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Department of Nuclear Medicine, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Incheon, Korea.



The study evaluated the significance of 18F fluorodeoxyglucose (18F-FDG) uptake of bone marrow (BM) for predicting progression-free survival (PFS) in lymphoma patients without BM involvement.


Ninety-five patients with histopathologically proven lymphoma, 7 Hodgkin's lymphoma and 88 non-Hodgkin's lymphoma, who underwent 18F-FDG positron emission tomography/computed tomography (PET/CT) and BM biopsy for staging work-up and 40 normal subjects were retrospectively enrolled. Maximal 18F-FDG uptake of lymphoma (Lmax), mean 18F-FDG uptake of BM (BM SUV) and BM-to-liver uptake ratio (BLR) were measured. Prognostic value of BM SUV and BLR for predicting PFS were assessed.


Of the 95 patients, 35 (36.8%) were histopathologically or clinically diagnosed with BM involvement of lymphoma. There were significant differences of BLR among lymphoma patients with/without BM involvement and normal subjects (P<0.05). For all patients, high risk indicated by International Prognostic Index (IPI) score and Lmax were significantly associated with PFS on multivariate analysis (P<0.05). For 60 patients without BM involvement, BM SUV and BLR were independent prognostic factors for PFS along with performance status and Lmax (p<0.05). Among patients without BM involvement, high 18F-FDG uptake of BM was associated with significantly worse PFS than low 18F-FDG uptake of BM, with no significant difference in PFS apparent compared to patients with BM involvement.


In lymphoma patients without BM involvement, 18F-FDG uptake of BM was significantly associated with worse PFS. Patients with high 18F-FDG uptake of BM showed similar prognosis to those with BM involvement.

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