• Kanhaiyalal Agrawal, Bhagwant Rai Mittal, Deepak Bansal, Neelam Varma, Radhika Srinivasan, Amita Trehan, Kuruva Manohar, Raghava Kashyap, Anish Bhattacharya, and Ram K Marwaha.
• Department of Nuclear Medicine and PET, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
• Ann Nucl Med. 2013 Feb 1; 27 (2): 146-51.

ObjectivesThe aim of the current study was to assess the utility of F-18-fluoro-2-deoxy-D-glucose (F-18 FDG) positron emission tomography/computed tomography (PET/CT) in assessing bone marrow involvement (BMI) compared to bone marrow biopsy (BMB) in initial staging of Hodgkin's lymphoma (HL) in pediatric patients.MethodsData of 38 pediatric patients (mean age 9.8 years, range 3-18 years) with HL were analyzed for the involvement of bone marrow. All patients underwent non-contrast F-18 FDG PET/CT study. BMB was done in 31 patients from the bilateral iliac crests. Scans were interpreted by two nuclear medicine physicians blinded to the details of BMB.ResultsOf the 31 patients who underwent BMB, 5 patients had lymphomatous involvement on BMB. PET/CT was positive in four of these five patients. In 26 patients negative on BMB, PET was negative in 23 patients and positive in 3 patients for BMI. The sensitivity and negative predictive value of F-18 FDG PET/CT was 87.5 and 96%, respectively, for BMI.ConclusionsF-18 FDG PET/CT can predict BMB results with high accuracy. F-18 FDG PET/CT may be used at initial staging of pediatric Hodgkin's lymphoma as it uncovers unsuspected BMI and BMB may be omitted in patients with PET-positive BMI.

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