Zapata CP, et al. - The accuracy of positron emission tomography–computed tomography (PET–CT) was compared with bone marrow biopsy (BMB) in the initial evaluation of bone marrow infiltration in pediatric cancers. PET–CT offered a high sensitivity when evaluating marrow infiltration in pediatric malignancies. Advances in radiologic modalities might obviate the use of invasive, painful, and costly procedures like BMB. Furthermore, biopsy results were limited by insufficient tissue or the degree of marrow infiltration. PET–CT could improve the precision of biopsy when used as a guiding tool. Thus, PET–CT was suggested as a first-line screening tool for bone marrow infiltration to improve the accuracy of staging in new diagnoses.

Methods

• The authors reviewed new cases of EWS, rhabdomyosarcoma, neuroblastoma, and lymphoma diagnosed between January 2009 and October 2014.
• Each case had undergone both PET–CT and BMB within 4 weeks without treatment in the interval between screening modalities.

Results

• In total 69 cases were reviewed.
• In 34 cases by PET–CT and in 18 cases by BMB, bone marrow infiltration was demonstrated.
• PET–CT offered 100% sensitivity and negative predictive value.
• Interestingly, the cases in which infiltration was not detected on BMB had an abnormal marrow signal on PET–CT focal or distant to iliac crest.