{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T18:16:29Z","timestamp":1778264189718,"version":"3.51.4"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,3,13]],"date-time":"2023-03-13T00:00:00Z","timestamp":1678665600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>To investigate the diagnostic performance of integrated whole-body <jats:sup>18<\/jats:sup>F-FDG PET\/MRI for detecting bone marrow involvement (BMI) in indolent lymphoma compared with <jats:sup>18<\/jats:sup>F-FDG PET or MRI alone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with treatment-naive indolent lymphoma who underwent integrated whole-body <jats:sup>18<\/jats:sup>F-FDG PET\/MRI and bone marrow biopsy (BMB) were prospectively enrolled. Agreement between PET, MRI, PET\/MRI, BMB, and the reference standard was assessed using kappa statistics. The sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of each method were calculated. A receiver operating characteristic (ROC) curve was used to determine the area under the curve (AUC). AUCs of PET, MRI, PET\/MRI, and BMB were compared using the DeLong test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty-five patients (24 males and 31 females; mean age: 51.1 \u00b1 10.1 years) were included in this study. Of these 55 patients, 19 (34.5%) had BMI. Two patients were upstaged as extra bone marrow lesions were detected <jats:italic>via<\/jats:italic> PET\/MRI. 97.1% (33\/34) of participants were confirmed as BMB-negative in the PET-\/MRI-group. PET\/MRI (parallel test) and BMB showed excellent agreement with the reference standard (k = 0.843, 0.918), whereas PET and MRI showed moderate agreement (k = 0.554, 0.577). The sensitivity, specificity, accuracy, PPV, and NPV for identifying BMI in indolent lymphoma were 52.6%, 97.2%, 81.8%, 90.9%, and 79.5%, respectively, for PET; 63.2%, 91.7%, 81.8%, 80.0%, and 82.5%, respectively, for MRI; 89.5%, 100%, 96.4%, 100%, and 94.7%, respectively, for BMB; and 94.7%, 91.7%, 92.7%, 85.7%, and 97.1%, respectively, for PET\/MRI (parallel test). According to ROC analysis, the AUCs of PET, MRI, BMB, and PET\/MRI (parallel test) for detecting BMI in indolent lymphomas were 0.749, 0.774, 0.947, and 0.932, respectively. The DeLong test showed significant differences between the AUCs of PET\/MRI (parallel test) and those of PET (P = 0.003) and MRI (P = 0.004). Regarding histologic subtypes, the diagnostic performance of PET\/MRI for detecting BMI in small lymphocytic lymphoma was lower than that in follicular lymphoma, which was in turn lower than that in marginal zone lymphoma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Integrated whole-body <jats:sup>18<\/jats:sup>F-FDG PET\/MRI showed excellent sensitivity and accuracy for detecting BMI in indolent lymphoma compared with <jats:sup>18<\/jats:sup>F-FDG PET or MRI alone, demonstrating that <jats:sup>18<\/jats:sup>F-FDG PET\/MRI is an optimal method and a reliable alternative to BMB.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration<\/jats:title><jats:p><jats:uri>ClinicalTrials.gov<\/jats:uri> (NCT05004961 and NCT05390632)<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2023.1136687","type":"journal-article","created":{"date-parts":[[2023,3,13]],"date-time":"2023-03-13T05:03:24Z","timestamp":1678683804000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Diagnostic performance of integrated whole-body 18F-FDG PET\/MRI for detecting bone marrow involvement in indolent lymphoma: Comparison with 18F-FDG PET or MRI 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