Have a personal or library account? Click to login
The utility of 18F-FDG PET/CT in assessing bone marrow involvement and prognosis in newly diagnosed diffuse large B-cell lymphoma Cover

The utility of 18F-FDG PET/CT in assessing bone marrow involvement and prognosis in newly diagnosed diffuse large B-cell lymphoma

Radiology and Oncology
Volume 59 (2025): Issue 4 (December 2025)
By: Chunyan Yang,  Hong Liu,  Furui Duan,  Ximei Wang,  Ping Li and  Dalong Wang  
Open Access
|Dec 2025

References

  1. Alaggio R, Amador C, Anagnostopoulos I, Attygalle AD, Araujo IBdO, Berti E, et al. The 5th edition of the World Health Organization classification of haematolymphoid tumours: lymphoid neoplasms. Leukemia 2022; 36: 1720-48. doi: 10.1038/s41375-022-01620-2
    Open DOISearch in Google ScholarBack to article
  2. Teagle AR, Barton H, Charles-Edwards E, Dizdarevic S, Chevassut T. Use of FDG PET/CT in identification of bone marrow involvement in diffuse large B cell lymphoma and follicular lymphoma: comparison with iliac crest bone marrow biopsy. Acta Radiologica 2017; 58: 1476-84. doi: 10.1177/0284185117701305
    Open DOISearch in Google ScholarBack to article
  3. Hopkins E, Devenish G, Evans G, Leopold G, Rees J and Parry-Jones N. Subcutaneous seeding of ‘double hit’ diffuse large B-cell lymphoma from staging bone marrow biopsy. Br J Haematol 2014; 166: 635-5. doi: 10.1111/bjh.12979
    Open DOISearch in Google ScholarBack to article
  4. Adams HJA, de Klerk JMH, Fijnheer R, Heggelman BGF, Dubois SV, Nievelstein RAJ, et al. Bone marrow biopsy in diffuse large B-cell lymphoma: useful or redundant test? Acta Oncol 2014; 54: 67-72. doi: 10.3109/0284186x.2014.958531
    Open DOISearch in Google ScholarBack to article
  5. Tilly H, Gomes da Silva M, Vitolo U, Jack A, Meignan M, Lopez-Guillermo A, et al. Diffuse large B-cell lymphoma (DLBCL): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2015; 26: v116-25. doi: 10.1093/annonc/mdv304
    Open DOISearch in Google ScholarBack to article
  6. Doma A, Zevnik K, Studen A, Prevodnik VK, Gasljevic G, Novakovic BJ. Detection performance and prognostic value of initial bone marrow involvement in diffuse large B-cell lymphoma: a single centre 18F-FDG PET/CT and bone marrow biopsy evaluation study. Radiol Oncol 2024; 58: 15-22. doi: 10.2478/raon-2024-0004
    Open DOISearch in Google ScholarBack to article
  7. Chen Y, Xu J, Meng J, Ding M, Guo Y, Fu D, et al. Establishment and evaluation of a nomogram for predicting the survival outcomes of patients with diffuse large B-cell lymphoma based on International Prognostic Index scores and clinical indicators. Ann Transl Med 2023; 11: 71. doi: 10.21037/atm-22-6023
    Open DOISearch in Google ScholarBack to article
  8. Kaddu-Mulindwa D, Altmann B, Held G, Angel S, Stilgenbauer S, Thurner L, et al. FDG PET/CT to detect bone marrow involvement in the initial staging of patients with aggressive non-Hodgkin lymphoma: results from the prospective, multicenter PETAL and OPTIMAL>60 trials. Eur J Nucl Med Mol Imaging 2021; 48: 3550-9. doi: 10.1007/s00259-021-05348-6
    Open DOISearch in Google ScholarBack to article
  9. Khan AB, Barrington SF, Mikhaeel NG, Hunt AA, Cameron L, Morris T, et al. PET-CT staging of DLBCL accurately identifies and provides new insight into the clinical significance of bone marrow involvement. Blood 2013; 122: 61-7. doi: 10.1182/blood-2012-12-473389
    Open DOISearch in Google ScholarBack to article
  10. Elamir Y, Elazab M, Owis AS, Elsayed HF. PET/CT and bone marrow biopsy (BMB) in evaluating bone marrow in lymphoma. Egypt J Radiol Nucl Med 2020; 51: doi: 10.1186/s43055-020-00318-8
    Open DOISearch in Google ScholarBack to article
  11. Büyükşimşek M, Kolsuz İ, Yetişir AE, Tohumcuoğlu M, Oğul A, Mirili C, et al. Performance of positron emission tomography-computed tomography and bone marrow biopsy in detecting bone marrow infiltration in lymphoma cases. Turk J Haematol 2020; 37: 220-5. doi: 10.4274/tjh. galenos.2020.2019.0361
    Open DOISearch in Google ScholarBack to article
  12. Berthet L, Cochet A, Kanoun S, Berriolo-Riedinger A, Humbert O, Toubeau M, et al. In newly diagnosed diffuse large B-cell lymphoma, determination of bone marrow involvement with 18F-FDG PET/CT provides better diagnostic performance and prognostic stratification than does biopsy. J Nucl Med 2013; 54: 1244-50. doi: 10.2967/jnumed.112.114710
    Open DOISearch in Google ScholarBack to article
  13. Pakos EE, Fotopoulos AD, Ioannidis JP. 18F-FDG PET for evaluation of bone marrow infltration in staging of lymphoma: a meta-analysis. J Nucl Med 2005; 46: 958-63. PMID: 15937306
    Search in Google ScholarBack to article
  14. Li Z, Li C, Chen B, Shi L, Gao F, Wang P, et al. FDG-PET/CT versus bone marrow biopsy in bone marrow involvement in newly diagnosed paediatric lymphoma: a systematic review and meta-analysis. J Orthop Surg Res 2021; 16: 485. doi: 10.1186/s13018-021-02521-3
    Open DOISearch in Google ScholarBack to article
  15. Adams HJA, Kwee TC, de Keizer B, Fijnheer R, de Klerk JMH, Nievelstein RAJ. FDG PET/CT for the detection of bone marrow involvement in diffuse large B-cell lymphoma: systematic review and meta-analysis. Eur J Nucl Med Mol Imaging 2013; 41: 565-74. doi: 10.1007/s00259-013-2623-4
    Open DOISearch in Google ScholarBack to article
  16. El Karak F, Bou-Orm IR, Ghosn M, Kattan J, Farhat F, Ibrahim T, et al. PET/CT scanner and bone marrow biopsy in detection of bone marrow involvement in diffuse large B-cell lymphoma. PLoS One 2017; 12: e0170299. doi: 10.1371/journal.pone.0170299
    Open DOISearch in Google ScholarBack to article
  17. Al-Sabbagh A, Ibrahim F, Szabados L, Soliman DS, Taha RY, Fernyhough LJ. The role of integrated positron emission tomography/computed tomography (PET/CT) and bone marrow examination in staging large B-cell lymphoma. Clin Med Insights Oncol 2020; 14: 1179554920953091. doi: 10.1177/1179554920953091
    Open DOISearch in Google ScholarBack to article
  18. Mittal BR, Manohar K, Malhotra P, Das R, Kashyap R, Bhattacharya A, et al. Can fluorodeoxyglucose positron emission tomography/computed tomography avoid negative iliac crest biopsies in evaluation of marrow involvement by lymphoma at time of initial staging? Leuk Lymphoma 2011; 52: 2111-6. doi: 10.3109/10428194.2011.593273
    Open DOISearch in Google ScholarBack to article
  19. Chen-Liang TH, Martín-Santos T, Jerez A, Rodríguez-García G, Senent L, Martínez-Millán C, et al. Bone marrow biopsy superiority over PET/CT in predicting progression-free survival in a homogeneously-treated cohort of diffuse large B-cell lymphoma. Cancer Med 2017; 6: 2507-14. doi: 10.1002/cam4.1205
    Open DOISearch in Google ScholarBack to article
  20. Pelosi E, Penna D, Douroukas A, Bellò M, Amati A, Arena V, et al. Bone marrow disease detection with FDG-PET/CT and bone marrow biopsy during the staging of malignant lymphoma: results from a large multicentre study. Q J Nucl Med Mol Imaging 2011; 55: 469-75. PMID: 21150862
    Search in Google ScholarBack to article
  21. Hong J, Lee Y, Park Y, Kim SG, Hwang KH, Park SH, et al. Role of FDG-PET/CT in detecting lymphomatous bone marrow involvement in patients with newly diagnosed diffuse large B-cell lymphoma. Ann Hematol 2011; 91: 687-95. doi: 10.1007/s00277-011-1353-6
    Open DOISearch in Google ScholarBack to article
  22. Adams HJA, Kwee TC, Fijnheer R, Dubois SV, Nievelstein RAJ, de Klerk JMH. Bone marrow 18F-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography cannot replace bone marrow biopsy in diffuse large B-cell lymphoma. Am J Hematol 2014; 89: 726-31. doi: 10.1002/ajh.23730
    Open DOISearch in Google ScholarBack to article
  23. Zhou M, Chen Y, Liu J, Huang G. A predicting model of bone marrow malignant infiltration in 18F-FDG PET/CT images with increased diffuse bone marrow FDG uptake. J Cancer 2018; 9: 1737-44. doi: 10.7150/jca.24836
    Open DOISearch in Google ScholarBack to article
  24. Lim CH, Hyun SH, Cho YS, Choi JY, Lee KH. Prognostic significance of bone marrow 2-[18F]-fluoro-2-deoxy-d-glucose uptake in diffuse large B-cell lymphoma: relation to iliac crest biopsy results. Clin Radiol 2021; 76: 550. e19-550.e28. doi: 10.1016/j.crad.2021.02.023
    Open DOISearch in Google ScholarBack to article
  25. Xiao-Xue W, Xinyue H, Lijun Z. Whole body FDG-PET/CT for the assessment of bone marrow infiltration in patients with newly diagnosed lymphoma. Med Clin (Barc) 2020; 154: 61-5. doi: 10.1016/j.medcli.2019.07.022
    Open DOISearch in Google ScholarBack to article
  26. Paone G, Itti E, Haioun C, Gaulard P, Dupuis J, Lin C, et al. Bone marrow involvement in diffuse large B-cell lymphoma: correlation between FDG-PET uptake and type of cellular infiltrate. Eur J Nucl Med Mol Imaging 2008; 36: 745-50. doi: 10.1007/s00259-008-1021-9
    Open DOISearch in Google ScholarBack to article
  27. Alzahrani M, El-Galaly TC, Hutchings M, Hansen JW, Loft A, Johnsen HE, et al. The value of routine bone marrow biopsy in patients with diffuse large B-cell lymphoma staged with PET/CT: a Danish-Canadian study. Ann Oncol 2016; 27: 1095-9. doi: 10.1093/annonc/mdw137
    Open DOISearch in Google ScholarBack to article
  28. Vishnu P, Wingerson A, Lee M, Mandelson MT, Aboulafia DM. Utility of bone marrow biopsy and aspirate for staging of diffuse large B cell lymphoma in the era of positron emission tomography with 2-deoxy-2-[Fluorine-18]fluoro-deoxyglucose integrated with computed tomography. Clin Lymphoma Myeloma Leuk 2017; 17: 631-6. doi: 10.1016/j. clml.2017.06.010
    Open DOISearch in Google ScholarBack to article
  29. Chen J, Zhao Y. Pre-treatment [18F]FDG PET/CT for assessing bone marrow involvement and prognosis in patients with newly diagnosed peripheral T-cell lymphoma. Hematology 2024; 29: doi: 10.1080/16078454.2024.2325317
    Open DOISearch in Google ScholarBack to article
  30. El-Azony A, Basha MAA, Almalki YE, Abdelmaksoud B, Hefzi N, Alnagar AA, et al. The prognostic value of bone marrow retention index and bone marrow-to-liver ratio of baseline 18F-FDG PET/CT in diffuse large B-cell lymphoma. Eur Radiol 2023; 34: 2500-11. doi: 10.1007/s00330-023-10150-z
    Open DOISearch in Google ScholarBack to article
  31. Koh Y, Lee JM, Woo GU, Paeng JC, Youk J, Yoon SS, et al. FDG PET for evaluation of bone marrow status in T-cell lymphoma. Clin Nucl Med 2019; 44: 4-10. doi: 10.1097/rlu.0000000000002320
    Open DOISearch in Google ScholarBack to article
DOI: https://doi.org/10.2478/raon-2025-0062 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099
Journal RSS Feed
Language: English
Page range: 488 - 497
Submitted on: Feb 23, 2025
|
Accepted on: Aug 26, 2025
|
Published on: Dec 16, 2025
Published by: Association of Radiology and Oncology
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year
Keywords:
PET/CT,
DLBCL,
bone marrow biopsy,
bone marrow involvement
Related subjects:
Medicine,
Clinical medicine,
Internal medicine,
Haematology, oncology,
Radiology

© 2025 Chunyan Yang, Hong Liu, Furui Duan, Ximei Wang, Ping Li, Dalong Wang, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution 4.0 License.

Previous articleVolume 59 (2025): Issue 4 (December 2025)Next article