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- Title
The diagnostic value of F-FDG PET and MRI in paediatric histiocytosis.
- Authors
Mueller, Wolfgang; Melzer, Henriette; Schmid, Irene; Coppenrath, Eva; Bartenstein, Peter; Pfluger, Thomas
- Abstract
Purpose: To analyse the diagnostic value of F-FDG PET and MRI for the evaluation of active lesions in paediatric Langerhans cell histiocytosis. Methods: We compared 21 F-FDG PET scans with 21 MRI scans (mean time interval 17 days) in 15 patients (11 male, 4 female, age range 4 months to 19 years) with biopsy-proven histiocytosis. Primary criteria for the lesion-based analysis were signs of vital histiocyte infiltrates (bone marrow oedema and contrast enhancement for MRI; SUV greater than the mean SUV of the right liver lobe for PET). PET and MR images were analysed separately and side-by-side. The results were validated by biopsy or follow-up scans after more than 6 months. Results: Of 53 lesions evaluated, 13 were confirmed by histology and 40 on follow-up investigations. The sensitivity and specificity of PET were 67 % and 76 % and of MRI were 81 % and 47 %, respectively. MRI showed seven false-positive bone lesions after successful chemotherapy. PET showed five false-negative small bone lesions, one false-negative lesion of the skull and three false-negative findings for intracerebral involvement. PET showed one false-positive lesion in the lymphoid tissue of the head and neck region and two false-positive bone lesions after treatment. Combined PET/MR analysis decreased the number of false-negative findings on primary staging, whereas no advantage over PET alone was seen in terms of false-positive or false-negative results on follow-up. Conclusion: Our retrospective analysis suggests a pivotal role of F-FDG PET in lesion follow-up due to a lower number of false-positive findings after chemotherapy. MRI showed a higher sensitivity and is indispensable for primary staging, evaluation of brain involvement and biopsy planning. Combined MRI/PET analysis improved sensitivity by decreasing the false-negative rate during primary staging indicating a future role of simultaneous whole-body PET/MRI for primary investigation of paediatric histiocytosis.
- Subjects
POSITRON emission tomography; LANGERHANS-cell histiocytosis; TUMORS in children; LANGERHANS cells; MACROPHAGES
- Publication
European Journal of Nuclear Medicine & Molecular Imaging, 2013, Vol 40, Issue 3, p356
- ISSN
1619-7070
- Publication type
Article
- DOI
10.1007/s00259-012-2278-6