The relation of bone marrow scintigraphy and unilateral bone marrow biopsy in malignant lymphoma

To assess the diagnostic role of bone marrow scintigraphy (BMS) for detecting bone marrow infiltration by malignant lymphomas, 47 patients, 14 with malignant Hodgkin's and 33 with non-Hodgkin's lymphoma underwent BMS with 99mTc-sulphur-colloid and also unilateral iliac crest bone marrow biopsy (BMB). BM involvement in BMB was observed in 11 of the 47 patients. Four of these patients also had BMS lesions. Eight patients had BMS lesions not detected by BMB. There was poor agreement between the two modalities (kappa=0.137). Considering BMB as the gold standard, sensitivity, specificity, positive predictive value, negative predictive value and accuracy of BMS were 36%, 77%, 33%, 80%, and 68% respectively. In conclusion, BMS has a high negative predictive value and may be used as a complementary screening test for lymphoma to assess the extent of BM involvement, especially if magnetic resonance imaging-guided biopsy or positron emission tomography studies are not available, as is the case in developing countries.