Skip to main content

Advertisement

Log in

The usefulness of F-18 fluorodeoxyglucose positron emission tomography/computed tomography in patients with Langerhans cell histiocytosis

  • Original article
  • Published:
Annals of Nuclear Medicine Aims and scope Submit manuscript

Abstract

Objective

Langerhans cell histiocytosis (LCH) has a wide spectrum of clinical manifestations, ranging from spontaneous resolution to rapid progression or death, with the risk of permanent consequences. F-18 FDG PET/CT has been used for assessment of LCH patients. However, its clinical implication has not been well elucidated, mainly due to very low incidence of LCH. The aim of this study was to evaluate the clinical usefulness of F-18 FDG PET/CT in LCH patients.

Methods

A database of 12 patients (mean age 17.8 ± 17.9 years; 7 children, 5 adults) who were diagnosed histopathologically as LCH was retrospectively reviewed. Two patients underwent F-18 FDG PET/CT before and after therapy, 6 patients underwent only before therapy and 4 patients underwent only after therapy.

Results

Nine (75.0 %) and 3 patients (25.0 %) had single-system (single site and multiple sites) and multisystem involvements, respectively. Pretreatment SUVmax of patients with multisystem or multiple site involvement of a single-system was significantly higher than that of patients with single site involvement of a single-system (3.29 ± 2.52 vs. 1.63 ± 0.52, p = 0.025). One patient showed multisystem risk organs (lung and bone marrow) involvement. In 2 patients, F-18 FDG PET/CT detected additional active LCH lesions not identified on conventional imaging modalities. In follow-up F-18 FDG PET/CT scans, complete resolution was identified in 2 patients and reactivation in another 2 patients.

Conclusions

Results of this study suggest that F-18 FDG PET/CT is useful for identification of active lesions, stratification of disease stages, monitoring of therapeutic response, and detection of reactivation in LCH patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Abla O, Egeler RM, Weitzman S. Langerhans cell histiocytosis: current concepts and treatments. Cancer Treat Rev. 2010;36(4):354–9.

    Article  PubMed  CAS  Google Scholar 

  2. Arkader A, Glotzbecker M, Hosalkar HS, Dormans JP. Primary musculoskeletal Langerhans cell histiocytosis in children: an analysis for a 3-decade period. J Pediatr Orthop. 2009;29(2):201–7.

    Article  PubMed  Google Scholar 

  3. Azouz EM, Saigal G, Rodriguez MM, Podda A. Langerhans’ cell histiocytosis: pathology, imaging and treatment of skeletal involvement. Pediatr Radiol. 2005;35(2):103–15.

    Article  PubMed  Google Scholar 

  4. Bar-Shalom R, Yefremov N, Guralnik L, Gaitini D, Frenkel A, Kuten A, et al. Clinical performance of PET/CT in evaluation of cancer: additional value for diagnostic imaging and patient management. J Nucl Med. 2003;44(8):1200–9.

    PubMed  Google Scholar 

  5. Beverley PC, Egeler RM, Arceci RJ, Pritchard J. The Nikolas Symposia and histiocytosis. Nat Rev Cancer. 2005;5(6):488–94.

    Article  PubMed  CAS  Google Scholar 

  6. Beyer T, Townsend DW, Brun T, Kinahan PE, Charron M, Roddy R, et al. A combined PET/CT scanner for clinical oncology. J Nucl Med. 2000;41(8):1369–79.

    PubMed  CAS  Google Scholar 

  7. Binkovitz LA, Olshefski RS, Adler BH. Coincidence FDG-PET in the evaluation of Langerhans’ cell histiocytosis: preliminary findings. Pediatr Radiol. 2003;33(9):598–602.

    Article  PubMed  Google Scholar 

  8. Chu T, D’Angio GJ, Favara BE, Ladisch S, Nesbit M, Pritchard J. Histiocytosis syndromes in children. Lancet. 1987;2(8549):41–2.

    Article  PubMed  CAS  Google Scholar 

  9. Czernin J, Allen-Auerbach M, Schelbert HR. Improvements in cancer staging with PET/CT: literature-based evidence as of September 2006. J Nucl Med. 2007;48(Suppl 1):78S–88S.

    PubMed  CAS  Google Scholar 

  10. Favara BE, Steele A. Langerhans cell histiocytosis of lymph nodes: a morphological assessment of 43 biopsies. Pediatr Pathol Lab Med. 1997;17(5):769–87.

    Article  PubMed  CAS  Google Scholar 

  11. Garcia Gallo MS, Martinez MP, Abalovich MS, Gutierrez S, Guitelman MA. Endocrine manifestations of Langerhans cell histiocytosis diagnosed in adults. Pituitary. 2010;13(4):298–303.

    Article  PubMed  CAS  Google Scholar 

  12. Jubran RF, Marachelian A, Dorey F, Malogolowkin M. Predictors of outcome in children with Langerhans cell histiocytosis. Pediatr Blood Cancer. 2005;45(1):37–42.

    Article  PubMed  Google Scholar 

  13. Kaste SC, Rodriguez-Galindo C, McCarville ME, Shulkin BL. PET–CT in pediatric Langerhans cell histiocytosis. Pediatr Radiol. 2007;37(7):615–22.

    Article  PubMed  Google Scholar 

  14. Krajicek BJ, Ryu JH, Hartman TE, Lowe VJ, Vassallo R. Abnormal fluorodeoxyglucose PET in pulmonary Langerhans cell histiocytosis. Chest. 2009;135(6):1542–9.

    Article  PubMed  Google Scholar 

  15. Lahey E. Histiocytosis x—an analysis of prognostic factors. J Pediatr. 1975;87(2):184–9.

    Article  PubMed  CAS  Google Scholar 

  16. Lau LM, Stuurman K, Weitzman S. Skeletal Langerhans cell histiocytosis in children: permanent consequences and health-related quality of life in long-term survivors. Pediatr Blood Cancer. 2008;50(3):607–12.

    Article  PubMed  Google Scholar 

  17. Minkov M, Prosch H, Steiner M, Grois N, Potschger U, Kaatsch P, et al. Langerhans cell histiocytosis in neonates. Pediatr Blood Cancer. 2005;45(6):802–7.

    Article  PubMed  CAS  Google Scholar 

  18. Phillips M, Allen C, Gerson P, McClain K. Comparison of FDG-PET scans to conventional radiography and bone scans in management of Langerhans cell histiocytosis. Pediatr Blood Cancer. 2009;52(1):97–101.

    Article  PubMed  Google Scholar 

  19. Satter EK, High WA. Langerhans cell histiocytosis: a review of the current recommendations of the Histiocyte Society. Pediatr Dermatol. 2008;25(3):291–5.

    Article  PubMed  Google Scholar 

  20. Stalemark H, Laurencikas E, Karis J, Gavhed D, Fadeel B, Henter JI. Incidence of Langerhans cell histiocytosis in children: a population-based study. Pediatr Blood Cancer. 2008;51(1):76–81.

    Article  PubMed  Google Scholar 

  21. Udayasankar UK, Alazraki AL, Simoneaux SF. Role of PET/CT in congenital histiocytosis. Pediatr Radiol. 2010;40(Suppl 1):S57–61.

    Article  PubMed  Google Scholar 

  22. Van Nieuwenhuyse JP, Clapuyt P, Malghem J, Everarts P, Melin J, Pauwels S, et al. Radiographic skeletal survey and radionuclide bone scan in Langerhans cell histiocytosis of bone. Pediatr Radiol. 1996;26(10):734–8.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Byeong-Cheol Ahn.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lee, H.J., Ahn, BC., Lee, SW. et al. The usefulness of F-18 fluorodeoxyglucose positron emission tomography/computed tomography in patients with Langerhans cell histiocytosis. Ann Nucl Med 26, 730–737 (2012). https://doi.org/10.1007/s12149-012-0635-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12149-012-0635-y

Keywords

Navigation