Role of 18F-FDG PET/CT in the diagnosis and management of patients with Langerhans cell histiocytosis

Luo, Zhehuang; Lu, Pu-Xuan; Qi, Wan-Lin; Li, Fengxiang; Jin, Ai-Fang; Zen, Qing-Yun

doi:10.21037/qims-21-823

“…2-[ 18 F]FDG PET/CT is recommended in the current National Comprehensive Cancer Network (NCCN) guidelines for staging and response assessment [80]. Multiple studies have demonstrated the utility of 2-[ 18 F]FDG PET/CT to detect more lesions than conventional imaging in multiple sites [81][82][83][84]. Jessop et al reported a sensitivity and specificity of 100% and 83%, respectively, with low false positive rates [79].…”

Section: Langerhans-cell Histiocytosismentioning

confidence: 99%

The Impact of PET/CT on Paediatric Oncology

Brink

¹

,

Hlongwa

²

,

More

³

2023

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This review paper will discuss the use of positron emission tomography/computed tomography (PET/CT) in paediatric oncology. Functional imaging with PET/CT has proven useful to guide treatment by accurately staging disease and limiting unnecessary treatments by determining the metabolic response to treatment. 18F-Fluorodeoxyglucose (2-[18F]FDG) PET/CT is routinely used in patients with lymphoma. We highlight specific considerations in the paediatric population with lymphoma. The strengths and weaknesses for PET/CT tracers that compliment Meta-[123I]iodobenzylguanidine ([123I]mIBG) for the imaging of neuroblastoma are summarized. 2‑[18F]FDG PET/CT has increasingly been used in the staging and evaluation of disease response in sarcomas. The current recommendations for the use of PET/CT in sarcomas are given and potential future developments and highlighted. 2-[18F]FDG PET/CT in combination with conventional imaging is currently the standard for disease evaluation in children with Langerhans-cell Histiocytosis (LCH) and the non-LCH disease spectrum. The common pitfalls of 2-[18F]FDG PET/CT in this setting are discussed.

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“…Pulmonary cancer is the most common malignancy worldwide, and is considered the leading cause of cancer-related deaths globally ( 1 ). As an accurate noninvasive imaging method, positron emission tomography/computed tomography (PET/CT) with 2-[ 18 F]-fluoro-2-deoxy-D-glucose ( 18 F-FDG) has received widespread clinical recognition for the diagnosis and evaluation of pulmonary lesions ( 2 - 4 ). In clinical practice, a PET/CT examination is currently mainly performed as static imaging, and the data are evaluated in units of standardized uptake value (SUV) ( 5 , 6 ).…”

Section: Introductionmentioning

confidence: 99%

Quantitative parameters of static imaging and fast kinetics imaging in 18F-FDG total-body PET/CT for the assessment of histological feature of pulmonary lesions

Meng,

Zhang,

Ren

et al. 2023

Quant Imaging Med Surg

1

0

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Background To investigate the value of quantitative parameters related to static imaging and fast kinetics imaging of total-body (TB) 2-[ 18 F]-fluoro-2-deoxy-D-glucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) in differentiating benign from malignant pulmonary lesions and squamous cell carcinoma (SCC) from adenocarcinoma (AC) and to analyze the correlation of each parameter with the Ki-67 index. Methods A total of 108 patients with pulmonary lesions from July 2021 to May 2022 in the Henan Provincial People’s Hospital, China, were consecutively recruited for TB 18 F-FDG PET/CT in this prospective study. Static imaging parameters maximum standardized uptake value (SUV max ) and fast kinetics imaging parameters transport constant (K 1 ), rate constants (k 2 ), time delay (t d ), and fractional blood volume (v b ) were calculated and compared. The area under the receiver operating characteristic (ROC) curve (AUC), Delong test, Logistic regression analyses, and Pearson correlation were used to assess diagnostic efficacy, find independent predictors and analyse correlations respectively. Results Malignant lesions had higher SUV max and K 1 and lower v b than benign lesions, and SCC had higher SUV max and K 1 and lower t d and v b than AC (all P<0.05). For the differentiation of benign and malignant lesions, SUV max , K 1 , and v b were independent predictors, and AUC (SUV max + K 1 + v b ) =0.909 (95% CI: 0.839–0.956), AUC (SUV max ) =0.883 (95% CI: 0.807–0.937), AUC (K 1 ) =0.810 (95% CI: 0.723–0.879), and AUC (v b ) =0.746 (95% CI: 0.653–0.825), where AUC (SUV max + K 1 + v b ) was significantly different from AUC (K 1 ), AUC (v b ) (Z=3.006, 3.965, all P<0.05). For the differentiation of SCC and AC, SUV max , K 1 , t d , and v b were independent predictors, and AUC (SUV max + K 1 + t d + v b ) =0.946 (95% CI: 0.840–0.991), AUC (SUV max ) =0.818 (95% CI: 0.680–0.914), AUC (K 1 ) =...

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“…Conventional imaging examinations, such as computed tomography (CT) or magnetic resonance imaging (MRI), and ultrasound can be used to assess the extent of involvement, guide biopsy and evaluate the treatment response ( 9 - 11 ). 18 F-fluorodeoxyglucose ( 18 F-FDG) positron emission tomography (PET)/CT plays an important role in evaluating LCH lesions, detecting new lesions, and monitoring treatment response ( 12 , 13 ). Compared with conventional imaging examination, 18 F-FDG PET/CT has a higher ability to detect lesions and can distinguish metabolically active lesions from inactive lesions ( 14 ).…”

Section: Introductionmentioning

confidence: 99%

The baseline metabolism parameters of 18F‑FDG PET/CT as promising prognostic biomarkers in pediatric Langerhans cell histiocytosis

Lu,

Wei,

Wang

et al. 2023

Quant Imaging Med Surg

0

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Background Langerhans cell histiocytosis (LCH) is a rare myeloid precursor cell inflammatory neoplasia, which agonizes, maims, and even kills patients. Although clinical outcomes have steadily improved over the past decades, the progression/relapse rate of LCH remains high. The purpose of this study was to evaluate the prognostic value of the pre-treatment metabolism parameters of baseline 18 F-fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F‑FDG PET/CT) in children with LCH. Methods This cross-sectional study retrospectively and consecutively included 37 children (24 males and 13 females; median age, 5.1 years; range, 2.4–7.8 years) with pre-treatment 18 F-FDG PET/CT from September 2020 to September 2022 in Nuclear Medicine Department, Beijing friendship hospital, Capital Medical University, Beijing, China. These patients were then all admitted to the hospital and diagnosed with LCH by biopsy, in Hematology Center, Beijing Children’s Hospital, Capital Medical University, Beijing, China. Five metabolism parameters of 18 F-FDG PET/CT were analyzed, including maximum standardized uptake, tumor-to-normal liver standard uptake value ratio, tumor-to-normal bone marrow standard uptake value ratio, sum of metabolic tumor volume (sMTV), and sum of total lesion glycolysis (sTLG) of all lesions. Patients were followed up for at least 1 year or until disease progression/relapse. Univariate and multivariate analyses of progression-free survival was performed. Results During follow-up, 11 (29.7%) patients had disease progression/relapse. Univariate analysis revealed that the risk organ involvement, the treatment response at the 5 th or 11 th week, pre-treatment sMTV, and sTLG were significantly associated with progression-free survival (P=0.024, 0.018, 0.006, 0.006, and 0.042, respectively). Multivariate COX analysis revealed that non-response at the 11 th week, pre-treatment sMTV >32.55 g/cm 3 , and sTLG >98.86 g (P=0.002, 0.020, 0.026, respectively) were risk factors for progression-free survival. Conclusions The baseline metabolism parameters of 18 F-FDG PET/CT could be promising imaging biomarkers for predicting prognosis in children with LCH.

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Role of 18F-FDG PET/CT in the diagnosis and management of patients with Langerhans cell histiocytosis

Cited by 5 publications

References 22 publications

The Impact of PET/CT on Paediatric Oncology

The Impact of PET/CT on Paediatric Oncology

Quantitative parameters of static imaging and fast kinetics imaging in 18F-FDG total-body PET/CT for the assessment of histological feature of pulmonary lesions

The baseline metabolism parameters of 18F‑FDG PET/CT as promising prognostic biomarkers in pediatric Langerhans cell histiocytosis

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