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FDG-PET/CT versus bone marrow biopsy in bone marrow involvement in newly diagnosed paediatric lymphoma: a systematic
Zhizhuo Li1, Chengxin Li1, Bingrong Chen1
1Department of Orthopedics, Peking University China-Japan Friendship School of Clinical Medicine, 2 Yinghuadong Road, Chaoyang District, Beijing, 100029, China.
Insights
Fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) is highly accurate for diagnosing bone marrow infiltration in pediatric lymphoma. This imaging technique significantly outperforms bone marrow biopsy (BMB) in diagnostic value.
Area of Science:
- Oncology
- Radiology
- Pediatrics
Background:
- Bone marrow infiltration (BMI) is a critical and challenging diagnostic stage in pediatric lymphoma.
- Early and accurate diagnosis of BMI is essential for effective treatment planning and patient outcomes.
Purpose of the Study:
- To evaluate the diagnostic accuracy of FDG-PET/CT for BMI in newly diagnosed pediatric lymphoma patients.
- To compare the efficacy of FDG-PET/CT with bone marrow biopsy (BMB) for BMI detection.
Main Methods:
- Systematic literature search of PubMed, EMBASE, and Cochrane Library.
- Inclusion of nine eligible studies for quantitative analysis.
- Independent data extraction and quality assessment by two reviewers.
Main Results:
- FDG-PET/CT demonstrated high pooled sensitivity (0.97) and specificity (0.99) for diagnosing BMI.
- FDG-PET/CT showed superior diagnostic performance compared to BMB, which had lower sensitivity (0.44).
- The area under the curve (AUC) for FDG-PET/CT was exceptionally high (1.00).
Conclusions:
- FDG-PET/CT is a highly valuable and accurate diagnostic tool for evaluating BMI in pediatric Hodgkin and non-Hodgkin lymphoma.
- FDG-PET/CT offers significantly greater diagnostic accuracy than BMB for assessing bone marrow involvement in pediatric lymphoma.
Background:
Bone marrow infiltration (BMI) is a devastating stage of paediatric lymphoma. Prompt diagnosis of BMI in newly diagnosed paediatric lymphoma patients is critical but can be very challenging at present.
Methods:
We systematically retrieved studies from PubMed, EMBASE, and the Cochrane Library. Data extraction and quality assessment were performed by two reviewers independently. A total of nine eligible studies were included in the quantitative analysis.
Results:
The pooled sensitivity and specificity of FDG-PET/CT for diagnosing BMI in newly diagnosed paediatric lymphoma patients were 0.97 (95% confidence interval [CI], 0.93 to 0.99) and 0.99 (95% CI, 0.98 to 0.99), respectively. The pooled PLR, NLR, and DOR were 79.9 (95% CI, 42.7 to 149.6), 0.03 (95% CI, 0.01 to 0.17), and 2414.6 (95% CI, 989.6 to 5891.4), respectively. The AUC of FDG-PET/CT for BMI was 1.00 (95% CI, 0.99 to 1.00). Compared with FDG-PET/CT, BMB had a lower pooled sensitivity (0.44, 95% CI, 0.34 to 0.55) and comparable pooled specificity (1.00, 95% CI, 0.92 to 1.00).
Conclusion:
Compared with BMB, FDG-PET/CT was a more valuable diagnostic method for evaluating BMI in paediatric Hodgkin and non-Hodgkin lymphoma patients with extremely high diagnostic accuracy.
