Is bone marrow biopsy and aspiration still mandatory when 18F-FDG PET/CT is available for the initial assessment of bone marrow metastasis in pediatric Ewing sarcoma?

作者全名：Du, Yifei; Zhao, Zhenzhen; Yang, Chao

作者地址：[Du, Yifei; Zhao, Zhenzhen; Yang, Chao] Chongqing Med Univ, Natl Clin Res Ctr Child Hlth & Disorders, Dept Surg Oncol,China Int Sci & Technol Cooperat B, Minist Educ,Key Lab Child Dev & Disorders,Children, Chongqing, Peoples R China; [Du, Yifei] Chongqing Med Univ, Yibin Hosp, Dept Pediat Surg, Childrens Hosp, Yibin, Peoples R China

通信作者：Yang, C (通讯作者)，Chongqing Med Univ, Natl Clin Res Ctr Child Hlth & Disorders, Dept Surg Oncol,China Int Sci & Technol Cooperat B, Minist Educ,Key Lab Child Dev & Disorders,Children, Chongqing, Peoples R China.

来源：FRONTIERS IN ONCOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001230148400001

JCR分区：Q2

影响因子：3.5

年份：2024

卷号：14

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：Ewing sarcoma; bone marrow; PET/CT; pediatric; overall survival

摘要：Purpose To compare the diagnostic value of 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (18F-FDG PET/CT) and bone marrow biopsy and aspiration (BMBA) for evaluating bone marrow metastases (BMM) in newly diagnosed pediatric Ewing sarcoma (ES).Material and methods To assess the diagnostic accuracy of 18F-FDG PET/CT against BMBA for marrow infiltration in ES patients, a retrospective analysis encompassed 103 ES patients from the Children's Hospital of Chongqing Medical University, spanning nine years, who underwent both 18F-FDG PET/CT and BMBA at the point of diagnosis.Results The median age of this study was 9.3(15 days to 17.1 years), 52(50.5%) patients were male. Among the cohort, 8 subjects received a BMM diagnosis via marrow cytology or histopathology, concomitant with positive 18F-FDG PET/CT findings. An additional 4 patients were identified with BMM solely through 18F-FDG PET/CT. No cytologically or histologically positive BMM were found in PET/CT-negative patients. Therefore, within this selected sample group, the 18F-FDG PET/CT imaging technique exhibited sensitivity of 100% and specificity of 95.8%. The five-year overall survival rate decreased from 57.5% among the entire cohort of patients to a mere 30% for individuals suffering from BMM.Conclusion Given these findings, the prevailing reliance on BMBA warrants reevaluation when 18F-FDG PET/CT is available, potentially heralding a shift towards less invasive diagnostic modalities in the management of ES.

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