925P - Role of FDG-PET in detecting bone marrow involvement in mature T-/NK-cell neoplasms

Date 08 October 2016
Event ESMO 2016 Congress
Session Poster Display
Topics Haematological Malignancies
Presenter Yoon Seok Choi
Citation Annals of Oncology (2016) 27 (6): 313-327. 10.1093/annonc/mdw375
Authors Y.S. Choi1, K. Kim2, I. Song1, Y.J. Yang3, H.J. Lee1, D. Jo1, S.Y. Park3, S. Kim1, H. Yun1
  • 1Department Of Internal Medicine, Chungnam National University College of Medicine, 301-721 - Daejeon/KR
  • 2Department Of Nuclear Medicine, Chungnam National University College of Medicine, 301-721 - Daejeon/KR
  • 3Department Of Internal Medicine, The Catholic University of Korea Daejeon St. Mary's Hospital, 301-723 - Daejeon/KR

Abstract

Background

The determination of bone marrow (BM) involvement of non-Hodgkin's lymphoma is based on blind BM biopsy, assessing only a small portion of the entire BM. Positron emission tomography using 18F-fluoro-2-deoxy-D-glucose (FDG-PET) has become an essential diagnostic procedure to enable more accurate staging in many types of lymphomas. Herein, we aimed to evaluate the role of FDG-PET in detecting BM involvement of T-/NK-cell lymphomas.

Methods

Patients who were diagnosed mature T-/NK-cell neoplasm according to the WHO classification and uniformly treated in a single center between Jan 2008 and Dec 2014 were examined. BM biopsy from bilateral iliac crests was performed for all subjects. FDG uptake in BM was interpreted in two ways: (1) visual assessment according to international harmonization project (IHP), (2) 5-point scale (Deauville criteria) based on SUVmax of iliac bone and L4 vertebral body relative to liver.

Results

Thirty-one patients were eligible for analysis, including 12 PTCL-NOS, 13 extranodal NK/T-cell lymphoma/nasal type, 5 angioimmunoblastic T cell lymphoma and 1 ALK+ anaplastic large cell lymphoma. Based on BM biopsy, 8 subjects (25.8%) showed BM involvement. According to IHP recommendations, only 2 patients (6.5%) revealed BM involvement in FDG-PET and they were also positive in BM biopsy. In contrast, 11 patients (35.5%) showed Deauville 4/5 of 5-point scale, including all 8 subjects positive for BM biopsy. FDG-PET interpretation based on Deauville criteria, associated with higher concordance rate (90.3%) with BM biopsy, however, was less powerful in predicting difference in overall survival between presence and absence of BM involvement.

Conclusions

While FDG-PET might provide with higher sensitivity in detection of BM involvement, the impact on prognostication of patients with T-/NK-cell lymphoma was limited. Taken together, FDG-PET cannot obviate the need for BM biopsy in mature T-/NK-cell neoplasms.

Clinical trial identification

Legal entity responsible for the study

N/A

Funding

Chungnam National University, Daejeon, Republic of Korea

Disclosure

All authors have declared no conflicts of interest.