{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T22:49:36Z","timestamp":1791413376028,"version":"4.3.3"},"reference-count":23,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"29","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["J Clin Oncol"],"published-print":{"date-parts":[[2026,10,10]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>\n                      Detection of bone marrow disease has been a major component of rhabdomyosarcoma (RMS) staging with bilateral bone marrow aspirates\/biopsies (BMAB) from the iliac crests considered the diagnostic gold standard. This study's goal was to determine if 2-\n                      <jats:sup>18<\/jats:sup>\n                      F-labeled fluorodeoxyglucose positron emission tomography\/computed tomography ([\n                      <jats:sup>18<\/jats:sup>\n                      F]FDG PET\/CT) or PET\/magnetic resonance imaging (MRI) may replace BMAB in RMS staging.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Patients were recruited in Europe and North America. Medical records, FDG PET\/CT or FDG PET\/MRI (PET), and BMAB reports were collected retrospectively. Images were re-reviewed by nuclear medicine physicians at the patients' home institutions if PET reports indicated increased FDG uptake at bone\/bone marrow sites or if tumor cells were detected in bone marrow samples.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>PET imaging and BMAB were performed before chemotherapy and tumor resection in 301 patients with FDG-avid RMS. Bone marrow metastases were detected by PET and BMAB in 54, by PET only in 24, and by BMAB only in one of 301 patients with FDG-avid primary tumors. Absence of bone marrow metastases was confirmed by PET and BMAB in 222 of 301 patients. These observations translated into 98% sensitivity and 90% specificity for PET in detecting bone marrow metastases when BMAB was considered as gold standard. FDG-avid marrow disease was patchy (1-5 foci) in one third of cases. Patients with marrow disease indicated by PET and BMAB had more FDG-avid bone marrow foci, more metastatic sites, and lower survival than those with marrow disease indicated by PET only, suggesting more advanced disease stages.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Bone marrow sampling may be omitted in patients without evidence of FDG-avid bone marrow disease by PET. If there are FDG-avid bone marrow lesions, further investigation by MRI and\/or biopsy should be considered.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/jco-25-03080","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T20:01:08Z","timestamp":1787601668000},"page":"2835-2847","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Omitting Bone Marrow Sampling in FDG-Avid Rhabdomyosarcoma With 2-[\n                    <sup>18<\/sup>\n                    F]FDG PET-Negative Marrow: Results From an International Retrospective Study"],"prefix":"10.1200","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9932-1944","authenticated-orcid":false,"given":"Federico","family":"Mercolini","sequence":"first","affiliation":[{"name":"Pediatric Hematology and Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, 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