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Applied Sciences
Volume 12
Issue 2
10.3390/app12020540
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Review
Peer-Review Record

FDG PET/CT versus Bone Marrow Biopsy for Diagnosis of Bone Marrow Involvement in Non-Hodgkin Lymphoma: A Systematic Review

Appl. Sci. 2022, 12(2), 540; https://0-doi-org.brum.beds.ac.uk/10.3390/app12020540
by Jawaher Almaimani 1,†, Charalampos Tsoumpas 1,2, Richard Feltbower 1 and Irene Polycarpou 3,*
Reviewer 1: Anonymous
Reviewer 2: Anonymous
Appl. Sci. 2022, 12(2), 540; https://0-doi-org.brum.beds.ac.uk/10.3390/app12020540
Submission received: 10 December 2021 / Revised: 27 December 2021 / Accepted: 30 December 2021 / Published: 6 January 2022
(This article belongs to the Special Issue Methods, Applications and Developments in Positron Emission Tomography)

Round 1

Reviewer 1 Report

The manuscript FDG PET/CT versus bone marrow biopsy for diagnosis of bone  marrow involvement in non-Hodgkin lymphoma: A systematic review by Almaimani et al. estimates the performance of FDG PET/CT and BMB in the detection of BMI in NHL patients, emphasizing advantages and disadvantages of both methods. The review  is well organized, the references are appropriate and updated.

Although there are quite a number of articles on similar topics, the authors emphasized the purpose of this meta-analysis, pointing to the emergence of new PRT / CT devices with improved lesion visualization. Also, meta-analyzes to date have mostly included certain NHL subtypes. Different NHT subtypes and only patients with a newly diagnosed NHL were included in this study, thus avoiding the factors, like the effects of chemotherapy, that could lead to false positive results.

Therefore, I think that the manuscript will be of interest to readers, and I suggest the acceptance of the manuscript in its present form.

Author Response

We are grateful to the reviewers for their constructive comments on our manuscript.

Reviewer 2 Report

Thank you for sharing your work. My questions and comments are listed below:

  1. Please discuss if any geographic region-specific study was performed (or included) in the review?
  2. Please discuss if patient age group can influence the outcome of this study or not?
  3. Line 418: please include references after “…. whereas in other studies...”

Author Response

We are grateful to the reviewers for their constructive comments on our manuscript. 

Point 1: Please discuss if any geographic region-specific study was performed (or included) in the review.

Response 1: We have updated the manuscript in order to address this comment by adding the following (lines 475-476): "Other factors that might affect the results include region specific and genetic related differences; these however were not possible to be investigated with the given data." 

Point 2: Please discuss if patient age group can influence the outcome of this study or not?

Response 2: We have added the following sentence in the updated manuscript (lines 477-483): "The pattern and degree of bone marrow metabolic activity changes with age and FDG distribution is consequently affected. Previous studies have already concluded that SUVmax in bone marrow is decreased with aging [65-66] and therefore differences among some studies evaluating PET/CT for BMI may be explained by possible variations in population ages in the samples used. However, the studies included in this review do not provide sufficient evidence to derive conclusions on how age-related changes might affect PET/CT performance."

Point 3: Line 418: please include references after “…. whereas in other studies...”

Response 3: We have added the relevant references in the updated manuscript. 

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