METHODS: DLBCL patients at HPP who underwent 18F-FDG PET/CT and BMB were recruited between November 2016 to February 2018. Two reviewers, blinded to the BMB results, evaluated the 18F-FDG PET/CT scans to identify and characterize BMI. The diagnostic performance of 18F-FDG PET/CT was calculated using the BMB histopathological evaluation as the reference standard.
RESULTS: A total of 21 DLBCL patients were enrolled. Seven patients demonstrated BMI on PET/CT (3 with multifocal uptake were concordant with BMB). Fourteen scans were negative for BMI and concordant with BMB. The sensitivity and specificity of 18F-FDG PET/CT scans for detecting BMI is 100% and 77.8%, respectively.
CONCLUSION: 18F-FDG PET/CT is excellent for ruling-out the presence of BMI. A negative 18F-FDG PET/CT scan for BMI can preclude the need for BMB in certain cases. Although 18F-FDG PET/CT can accurately detect BMI in multifocal pattern of infiltration, it cannot fully replace BMB, which is still considered as the gold standard for evaluating BMI in DLBCL.