Journal Article

The value of 18F-FDG PET/CT in Langerhans cell histiocytosis

An, Rongchen, Wang, Yunhua, Ma, Xiaowei

2024

Overview

Objective To investigate the value of 18F-FDG PET/CT in diagnosis and disease evaluation of Langerhans cell histiocytosis (LCH). Methods A retrospective analysis of 31 patients with LCH confirmed by histopathology was performed. A systematic analysis of the PET/CT imaging manifestations of LCH was performed, recording patients who were treated and receiving PET/CT for efficacy evaluation. In addition, clinical and laboratory data of LCH patients were collected, and the correlation between these data and PET/CT metabolic parameters was initially investigated. Results Of the 31 patients, thirty had at least 1 PET/CT positive lesions (96.7%), and one had only skin damage without abnormalities on PET/CT. Of 31 patients, fifteen (48.4%) had single system (SS) disease (9 cases with a single site and 6 cases with multiple sites) and 16 (51.6%) had multisystem (MS) disease (6 low risk and 10 high risk cases). The incidence of LCH lesions in the bone, lymphatic system, pituitary gland, liver, soft tissue, thyroid gland, thymus, and lungs was 20 cases (64.5%), 12 cases (38.7%), 3 cases (9.7%), 2 cases (6.5%), 2 cases (6.5%), 1 case (3.2%), 1 case (3.2%), and 8 cases (25.8%), respectively. A total of 21 PET/CT follow-up scanning were performed in 13 patients receiving chemotherapy, with 13 (61.9%) partial metabolic remission (PMR), 6 (28.6%) progressive metabolic disease (PMD), and 2 (9.5%) stable metabolic disease (SMD), according to PET Response Evaluation Criteria in Solid Tumors (PRECIST) 1.0. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and Lactic Dehydrogenase (LDH) were positively correlated with TTLG (total TLG) ( R 2  = 0.3256, 0.2409, 0.4205, P  < 0.05). The Re-examine SUVmax is positively correlated with re-examine LDH ( R 2  = 0.7285, P  < 0.05). Conclusions 18F-FDG PET/CT is an effective way to diagnose and evaluate LCH. PET metabolic parameters were associated with laboratory inflammatory markers, suggesting that 18F-FDG PET/CT may be helpful in evaluating disease activity of LCH.

• Publisher: Springer Nature Singapore,Springer Nature B.V
• Subject: Abnormalities / Autoimmune diseases / Blood / C-reactive protein / Chemotherapy / Computed tomography / Correlation / Effectiveness / Erythrocyte sedimentation rate / Fluorine isotopes / Fluorodeoxyglucose F18 / Histiocytosis / Histiocytosis, Langerhans-Cell - diagnostic imaging / Histiocytosis, Langerhans-Cell - therapy / Humans / Imaging / Lesions / Liver / Lymphatic system / Magnetic resonance imaging / Medical imaging / Medicine / Medicine & Public Health / Metabolic Diseases / Metabolic disorders / Metabolism / Nuclear Medicine / Original Article / Parameters / Patients / Pituitary / Pituitary gland / Positron emission / Positron emission tomography / Positron Emission Tomography Computed Tomography - methods / Radiology / Remission / Retrospective Studies / Soft tissues / Solid tumors / Statistical analysis / Thymus gland / Thyroid gland / X-rays