Abstract
BACKGROUND: To evaluate the efficacy of PET/CT using(18)F-FDG ((18)F-fluorodeoxyglucose) as a radiotracer compared to conventional bone marrow biopsy (BMB) in detecting infiltration to bone marrow (BM) in pediatric patients with lymphoma at the time of initial diagnosis. METHODS: 66 pediatric patients with lymphoma (47Hodgkin's and 19non-Hodgkin's lymphoma) were referred for initial staging by(18)F-FDG PET/CT study. All patients underwent bilateral iliac BMB and (18)F-FDG PET/CT scan with no more than 2 weeks interval in-between. Follow-up for at least 6 months was used as a reference standard to compare diagnostic performance between two modalities in detecting bone marrow infiltration (BMI). RESULTS: Sensitivity, specificity, accuracy, as well as positive and negative predictive values of (18)F-FDG PET/CT in detecting BMI were (80%, 86%, 85%, 63%, and 94%) in contrast to BMB (80%, 53%, 59%, 33%, and 90%) respectively. (18)F-FDG PET/CT was concordant to BMB in 39/66 patients (59%). CONCLUSION: (18)F-FDG PET/CT was more accurate and specific, with higher predictive values than BMB in detecting BMI during initial staging of pediatric lymphoma. In most pediatric lymphoma patients, (18)F-FDG PET/CT can be used instead of BMB to determine BMI during their initial staging process.