The diagnostic value of 18F-FDG PET and MRI in paediatric histiocytosis
The diagnostic value of 18F-FDG PET and MRI in paediatric histiocytosis
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DOI：
10.1007/s00259-012-2278-6
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发表时间：
2013-02-01
影响因子：
9.1
通讯作者：
Pfluger, Thomas
中科院分区：
文献类型：
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作者：
Mueller, Wolfgang Peter;Melzer, Henriette Ingrid;Pfluger, Thomas
为了分析F-18-FDG PET和MRI对评价儿童郎格罕细胞组织细胞增生症活动性病变的诊断价值，我们对15例（男11例，女4例，年龄4个月至19岁）经活检证实的组织细胞增生症患者进行了21次F-18-FDG PET和21次MRI扫描（平均时间间隔17天）的比较。基于病变的分析的主要标准是活体组织细胞浸润的体征（骨髓水肿和MRI的对比增强; PET的SUV大于右肝叶的平均SUV）。PET和MR图像分别进行了分析和并排。结果通过活检或超过6个月后的随访扫描进行验证。在评估的53个病变中，13个经组织学证实，40个经随访检查证实。PET的敏感性和特异性分别为67%和76%，MRI的敏感性和特异性分别为81%和47%.成功化疗后，MRI显示7个假阳性骨病变。PET显示5个假阴性小骨病变，1个颅骨假阴性病变和3个脑内受累的假阴性结果。PET显示治疗后头颈部淋巴组织中的1个假阳性病灶和2个假阳性骨病灶。联合PET/MR分析减少了原发分期的假阴性结果的数量，而在随访的假阳性或假阴性结果方面，单独PET没有优势。我们的回顾性分析表明，F-18-FDG PET在病变随访中的关键作用是由于化疗后假阳性结果的数量较低。MRI显示了较高的敏感性，是原发分期，评估脑受累和活检计划不可或缺的。联合MRI/PET分析通过降低主要分期期间的假阴性率提高了灵敏度，表明同时全身PET/MRI在儿科组织细胞增生症初步研究中的未来作用。
To analyse the diagnostic value of F-18-FDG PET and MRI for the evaluation of active lesions in paediatric Langerhans cell histiocytosis.We compared 21 F-18-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.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.Our retrospective analysis suggests a pivotal role of F-18-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.