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Skeleton/bone marrow involvement in patients with newly diagnosed Hodgkin’s lymphoma (HL) is an important predictor of adverse outcomes. Studies show that FDG-PET/CT upstages patients with uni- or multifocal skeleton/bone marrow uptake (BMU) when iliac crest bone marrow biopsy fails to find evidence of histology-proven involvement. The general recommendation is, therefore, that bone marrow biopsy can be avoided when FDG-PET/CT is performed at staging.

Classifications of focal skeleton/BMU can sometimes be challenging. Artificial intelligence (AI) is being developed to assist the observer by highlighting suspicious uptake in diagnostic images.

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