Mark Tann MD, Presenter: Nothing to Disclose

Salim Nauman, Abstract Co-Author: Nothing to Disclose

Srivasta Shivani, Abstract Co-Author: Nothing to Disclose

Brian Louis Mattingly MD, Abstract Co-Author: Nothing to Disclose

James W. Fletcher MD, Abstract Co-Author: Nothing to Disclose

To assess whether routine BMB remains necessary for staging lymphoma with availability of concurrent 18F-FDG PET/CT.

65 PET exams from 54 lymphoma patients from age 5 year to 75 years were retrospectively reviewed and analyzed. All patients had BMB and 18F-FDG PET/CT within 1 month of each other. Results of BMB were not available at the time of 18F-FDG PET/CT imaging.

PET/CT showed negative predictive value of 100% for bone marrow involvement if no nodal disease was seen. Six patients had lymphomatous involvement on BMB  (and PET/CT)  but PET/CT depicted FDG-avid bone/bone marrow/ visceral foci in 7 additional patients. However, the iliac crest site of BMB was not involved on 18F–FDG PET/CT on these additional 7 patients. In only one case did BMB show bone marrow disease not seen on PET/CT, however PET showed nodal disease.

18F-FDG PET/CT is highly sensitive and specific for diagnosis of bone/bone marrow lesions and visceral involvement in high grade lymphoma in comparison to conventional staging by BMB. Therefore routine BMB is likely unnecessary and not effective in correct staging.

The routine use of Bone marrow Biopsy for the initial staging and follow up of lymphoma patients is likely unneccesary in the era of routine PET/CT scanning.

Tann, M, Nauman, S, Shivani, S, Mattingly, B, Fletcher, J, Is Routine Bone Marrow Biopsy (BMB) for Lymphoma Indicated in the Era of PET/CT?.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11006221.html