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In newly diagnosed diffuse large B-cell lymphoma (DLBCL), the sensitivity of bone marrow biopsy (BMB) for the detection of bone marrow involvement (BMI) can be low because of sampling error if the BMI is focal and not diffuse. Although ¹⁸F-FDG PET/CT is now recommended for initial staging of DLBCL, its role regarding BMI is not well defined. This study evaluated whether ¹⁸F-FDG PET/CT, in comparison with BMB, is useful for the detection of BMI and predictive of outcome. From the 142 patients who were referred to our institution for newly diagnosed DLBCL from June 2006 to October 2011, 133 were retrospectively enrolled in our study. All patients underwent whole-body ¹⁸F-FDG PET/CT and a BMB from the iliac crest before any treatment. ¹⁸F-FDG PET/CT was considered positive for BMI in cases of uni- or multifocal bone marrow ¹⁸F-FDG uptake that could not be explained by benign findings on …