Complementary roles of bone scintigraphy and MR imaging in the detection and long-term follow-up of primary non-Hodgkin’s bone lymphoma in a child-case report
The aim of our report is to demonstrate the complementary roles of bone scintigraphy (BS), magnetic resonance imaging (MR), and positron emission tomography using 2-deoxy-2-[18F]fluoro-D-glucose (F-18-FDG PET/CT) in the diagnosis and treatment monitoring of a child with primary non-Hodgkin’s lymphom...
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Published in | Skeletal radiology Vol. 44; no. 6; pp. 863 - 868 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
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Berlin/Heidelberg
Springer Berlin Heidelberg
01.06.2015
Springer Springer Nature B.V |
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Abstract | The aim of our report is to demonstrate the complementary roles of bone scintigraphy (BS), magnetic resonance imaging (MR), and positron emission tomography using 2-deoxy-2-[18F]fluoro-D-glucose (F-18-FDG PET/CT) in the diagnosis and treatment monitoring of a child with primary non-Hodgkin’s lymphoma of bone (PLB). Increased blood flow, high tissue accumulation, and markedly increased uptake on the late BS pointed toward an active bone process in the left femoral region. Bone marrow infiltration of the left femur and cortical sclerosis, which were both demonstrated by MR imaging, were later confirmed as PLB by bone marrow biopsy. The normalizations of the flow and tissue phases of BS a year after treatment and during the entire follow-up were in keeping with inactive disease and clinical remission. However, even 8 years after treatment and complete remission, MR imaging demonstrated persistent unmodified bone marrow alteration and appreciable cortical involvement. A slightly increased metabolic activity of the left femoral epiphysis demonstrated by F-18-FDG PET/CT and mild activity in the same region on delayed BS were demonstrated in the late follow-up. Our results strongly suggest that BS and MR imaging should be included in the diagnostic algorithm of children with undefined bone symptoms. However, mild metabolic activity on the F-18-FDG PET/CT scan could not reliably differentiate between the presence or absence of disease in a patient with PLB in clinical remission. |
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AbstractList | The aim of our report is to demonstrate the complementary roles of bone scintigraphy (BS), magnetic resonance imaging (MR), and positron emission tomography using 2-deoxy-2-[18F]fluoro-D-glucose (F-18-FDG PET/CT) in the diagnosis and treatment monitoring of a child with primary non-Hodgkin's lymphoma of bone (PLB). Increased blood flow, high tissue accumulation, and markedly increased uptake on the late BS pointed toward an active bone process in the left femoral region. Bone marrow infiltration of the left femur and cortical sclerosis, which were both demonstrated by MR imaging, were later confirmed as PLB by bone marrow biopsy. The normalizations of the flow and tissue phases of BS a year after treatment and during the entire follow-up were in keeping with inactive disease and clinical remission. However, even 8 years after treatment and complete remission, MR imaging demonstrated persistent unmodified bone marrow alteration and appreciable cortical involvement. A slightly increased metabolic activity of the left femoral epiphysis demonstrated by F-18-FDG PET/CT and mild activity in the same region on delayed BS were demonstrated in the late follow-up. Our results strongly suggest that BS and MR imaging should be included in the diagnostic algorithm of children with undefined bone symptoms. However, mild metabolic activity on the F-18-FDG PET/CT scan could not reliably differentiate between the presence or absence of disease in a patient with PLB in clinical remission. The aim of our report is to demonstrate the complementary roles of bone scintigraphy (BS), magnetic resonance imaging (MR), and positron emission tomography using 2-deoxy-2-[18F]fluoro-D-glucose (F-18-FDG PET/CT) in the diagnosis and treatment monitoring of a child with primary non-Hodgkin’s lymphoma of bone (PLB). Increased blood flow, high tissue accumulation, and markedly increased uptake on the late BS pointed toward an active bone process in the left femoral region. Bone marrow infiltration of the left femur and cortical sclerosis, which were both demonstrated by MR imaging, were later confirmed as PLB by bone marrow biopsy. The normalizations of the flow and tissue phases of BS a year after treatment and during the entire follow-up were in keeping with inactive disease and clinical remission. However, even 8 years after treatment and complete remission, MR imaging demonstrated persistent unmodified bone marrow alteration and appreciable cortical involvement. A slightly increased metabolic activity of the left femoral epiphysis demonstrated by F-18-FDG PET/CT and mild activity in the same region on delayed BS were demonstrated in the late follow-up. Our results strongly suggest that BS and MR imaging should be included in the diagnostic algorithm of children with undefined bone symptoms. However, mild metabolic activity on the F-18-FDG PET/CT scan could not reliably differentiate between the presence or absence of disease in a patient with PLB in clinical remission. |
Audience | Academic |
Author | Vera, Artiko Marina, Vlajković Slađana, Petrović Milena, Rajić Vesna, Petronijević |
Author_xml | – sequence: 1 givenname: Vlajković surname: Marina fullname: Marina, Vlajković email: marinavly@sezampro.rs organization: Center of Nucler Medicine, Clinical Center Niš – sequence: 2 givenname: Rajić surname: Milena fullname: Milena, Rajić organization: Center of Nucler Medicine, Clinical Center Niš – sequence: 3 givenname: Petronijević surname: Vesna fullname: Vesna, Petronijević organization: Clinic of Physical Medicine, Rehabilitation and Prosthetics, Clinical Center Niš – sequence: 4 givenname: Petrović surname: Slađana fullname: Slađana, Petrović organization: Center of Radiology, Clinical Center Niš – sequence: 5 givenname: Artiko surname: Vera fullname: Vera, Artiko organization: Center of Nuclear Medicine, Clinical Center of Serbia |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/25433719$$D View this record in MEDLINE/PubMed |
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Cites_doi | 10.2106/JBJS.D.01967 10.2214/AJR.07.7138 10.1007/s00247-013-2656-7 10.1002/pbc.24406 10.1007/s004310000711 10.1148/rg.236025056 10.1002/1097-0142(19950215)75:4<973::AID-CNCR2820750412>3.0.CO;2-8 10.2214/AJR.13.11833 10.1007/s12032-009-9405-7 10.1016/S0001-2998(97)80006-2 10.2214/AJR.13.11239 10.1007/s002590000301 10.2214/ajr.184.1.01840185 10.1136/ard.53.10.631 10.1200/JCO.2002.06.017 10.5772/26863 10.1007/s00247-012-2610-0 10.1200/JCO.1999.17.2.456 |
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Keywords | Three-phase bone scintigraphy MR imaging Children F-18-FDG PET/CT Primary bone lymphoma |
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SubjectTerms | Adolescent Care and treatment Case Report Female Femoral Neoplasms - diagnosis Fluorodeoxyglucose F18 Follow-Up Studies Humans Imaging Longitudinal Studies Lymphoma, Non-Hodgkin - diagnosis Lymphomas Magnetic resonance imaging Magnetic Resonance Imaging - methods Medicine Medicine & Public Health Nuclear Medicine Orthopedics Pathology PET imaging Positron-Emission Tomography - methods Radiology Radiopharmaceuticals Vincristine |
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Title | Complementary roles of bone scintigraphy and MR imaging in the detection and long-term follow-up of primary non-Hodgkin’s bone lymphoma in a child-case report |
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