Assessment of bone marrow inflammation in patients with myelofibrosis: an 18F-fluorodeoxyglucose PET/CT study

Thorsten Derlin, Haefaa Alchalby, Peter Bannas, Simon Veldhoen, Ivayla Apostolova, Ioanna Triviai, Frank M. Bengel, Nicolaus Kröger

Research output: Contribution to journalArticlepeer-review


Purpose: Myelofibrosis is a haematopoietic stem cell neoplasm characterized by bone marrow inflammation, reactive marrow fibrosis and extramedullary haematopoiesis. The aim of this study was to determine if 18F-FDG PET/CT can be used to noninvasively visualize and quantify the extent and activity of bone marrow involvement.

Methods: In 30 patients, the biodistribution of 18F-FDG was analysed by measuring the standardized uptake value in the bone marrow compartment and spleen. Imaging findings were compared with laboratory, cytogenetic and histopathological data.

Results: Retention of 18F-FDG was observed in bone marrow and spleen. Bone marrow involvement varied, ranging from mildly increased uptake in the central skeleton to extensive uptake in most parts of the skeleton. The extent of bone marrow involvement decreased over time from initial diagnosis (rs = −0.43, p = 0.019). Metabolic activity of the bone marrow decreased as the histopathological grade of fibrosis increased (rs = −0.37, p = 0.04). There was a significant positive correlation between the metabolic activity of the bone marrow and that of the spleen (p = 0.04).

Conclusion: 18F-FDG PET/CT is as a promising technique for the quantitation of bone marrow inflammation in myelofibrosis. Our data indicate that the intensity of bone marrow 18F-FDG uptake decreases as bone marrow fibrosis increases. Further evaluation in prospective studies is required to determine the potential clinical impact and prognostic significance of PET.

Original languageEnglish (US)
Pages (from-to)696-705
Number of pages10
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Issue number5
StatePublished - Mar 5 2015


  • Bone marrow fibrosis
  • Extramedullary haematopoiesis
  • Inflammation
  • Myelofibrosis
  • Positron emission tomography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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