Is it sufficient to evaluate bone marrow involvement in newly diagnosed lymphomas using 18F-FDG PET/CT and/or routine iliac crest biopsy? A new approach of PET/CT-guided targeted bone marrow biopsy

Table 3 Sensitivity, Specificity, PPV, NPV, and Accuracy of the Iliac Crest Biopsy and PET/CT for Detection of Bone Marrow Disease in the 295 patients

Diagnostic Modality	%	95%CI		%	95%CI
	Bone Disease Defined Only by Positive Iliac crest biopsy (n = 55)
Iliac crest biopsy
Focal			Diffuse
Sensitivity	N/A^a		Sensitivity	N/A^a
Specificity	N/A^a		Specificity	N/A^a
PPV	N/A^a		PPV	N/A^a
NPV	N/A^a		NPV	N/A^a
Accuracy	N/A^a		Accuracy	N/A^a
PET/CT
Focal			Diffuse
Sensitivity	48	31 to 66	Sensitivity	56	40 to 72
Specificity	70	63 to 76	Specificity	83	77 to 88
PPV	20	12 to 31	PPV	42	30 to 57
NPV	90	84 to 94	NPV	90	84 to 90
Accuracy	67	61 to 73	Accuracy	78	72 to 83
	Bone Disease Defined Only by Positive Iliac crest biopsy and/or FDG-avid bone lesion (n = 148)
Iliac crest biopsy
Focal			Diffuse
Sensitivity	34	25 to 45	Sensitivity	57	44 to 68
Specificity	N/A^b		Specificity	N/A^b
PPV	N/A^b		PPV	N/A^b
NPV	70	63 to 76	NPV	83	77 to 88
Accuracy	74	68 to 79	Accuracy	86	81 to 90
PET/CT
Focal			Diffuse
Sensitivity	82^‡	71 to 88	Sensitivity	75^‡	63 to 85
Specificity	N/A^b		Specificity	N/A^b
PPV	N/A^b		PPV	N/A^b
NPV	90^‡	84 to 94	NPV	90^‡	84 to 94
Accuracy	93^‡	89 to 96	Accuracy	92^‡	88 to 95

Abbreviations: PET Positron emission tomography, CT Computed tomography, N/A Not applicable, NPV Negative predictive value, PPV Positive predictive value
^‡P < 0.05 for difference between the routine iliac crest biopsy and PET/CT for detection of bone marrow disease
^aN/A because iliac crest biopsy is considered the gold standard in this analysis
^bN/A because of missing reference for true positive

ISSN: 1471-2407