الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Lymphoma comprises a histologically heterogeneous group of cancers derived from the cells of the immune system. The hallmark of the disease is the enlargement and proliferation of lymph nodes or secondary lymphoid tissues. Once the diagnosis of lymphoma is made, the extent and sites of disease must be determined to assess the prognosis and to plan therapy.
Aссurate staging is сritiсal for identifying patients with early-stage (stage I or II) lymphoma, whiсh is treated with involved-field radiation therapy. Сhemotherapy is performed in patients with more advanсed stage disease (stage III or IV).Thus aссurate staging is the basis for the seleсtion of an appropriate therapeutiс approaсh, in order to prevent over or under treatment as well as to minimize morbidity related to the radio-сhemotherapy regimens given.
Diagnosis of bone marrow involvement in lymphoma has significant prognostic and therapeutic implications, as it upstages the disease to Ann Arbor stage IV. Bone marrow biopsy (BMB) from the iliac crest has been traditionally used for marrow evaluation. It is obtained from the dorsal portion of the iliac crest, which is the most accessible approach for BM evaluation. However, it is an invasive operation and it yields information from a limited area. In addition, BMB may provide false-negative results if samples are atypical or the lesions are focal and may require general anaesthesia in children.
In the last decade, PET/CT has been introduced into the field of oncologic imaging representing a unique imaging modality that scans the whole body integrating functional information from a PET scan with anatomical information from a CT scan. PET/CT has a significant impact on staging accuracy of lymphoma which interns influence the plan of management and prediction of outcome. It can not only detect a focal malignant bone marrow infiltration but also does not give rise to a painful experience.
18F-FDG PET provides global information about the entire bone marrow, beyond the biopsiable areas. Previous studies have reported the high sensitivity and accuracy of FDG-PET/CT in detecting BMI in Hodgkin lymphoma and Non-Hodgkin Lymphoma.
In our study PET-CT was able to evaluate the bone marrow and detection of its lymphomatous infiltration either diffuse or focal which resulted in upstaging of 5 (18.5%) cases of lymphoma patients who couldn’t be identified by BMB because it is limited to dorsal portion of the iliac crest incomparison to the PET/CT which gives an overview about the whole body marrow.
Finally, 18F-FDG PET-CT imaging is more sensitive than blind Bone Marrow Biopsy (BMB) from the posterior iliac crest for detection of bone marrow infiltration (BMI) in Hodgkin’s Lymphoma and Non-Hodgkin’s Lymphoma staging system.
Compliance with ethical standards
Conflicts of interest: None
Recommendations
More prospective studies are recommended with a larger sample size.