The role of 18F-FDG PET/CT in the management of patients with secondary haemophagocytic lymphohistiocytosis.
Clin Radiol
; 71(12): 1248-1254, 2016 Dec.
Article
in En
| MEDLINE
| ID: mdl-27387105
ABSTRACT
AIM:
To investigate the ability of combined 2-[18F]-fluoro-2-deoxy-d-glucose (18F-FDG) positron-emission tomography (PET)/computed tomography (CT) to determine potential causes of secondary haemophagocytic lymphohistiocytosis (sHLH) and to predict prognosis. MATERIAL ANDMETHODS:
Forty-three patients (male/female 20/23, median age 48.5 years), who were diagnosed with sHLH and underwent FDG-PET/CT before treatment, were retrospectively reviewed. The clinical characteristics were compared to identify the predictors of high-yield FDG-PET/CT. Univariate and multivariate analyses were conducted to identify factors associated with survival. Statistical analysis was performed using SPSS version 19.0.RESULTS:
PET results were helpful in 65.1% (28/43), whilst non-contributory in 34.9% (15/43) of patients with regard to the final diagnosis. Lymphoma was the most common (25/43) reason for sHLH, and patients with focal FDG uptake were more likely to be diagnosed with underlying diseases. C-reactive protein (CRP) was found to be a good indicator for the usefulness of PET/CT in HLH patients. Multivariate analysis showed that therapy regimen (hazard ratio [HR]=4.99, p=0.026), fibrinogen (FBG) <1.5 g/l (HR=3.87, p=0.049) and spleenmediastinum ratio (SP/M) (HR=7.44, p=0.006) were independent prognostic factors for survival.CONCLUSION:
FDG-PET/CT could be a useful technique for detecting underlying diseases causing sHLH. CRP was a useful predictor of FDG-PET/CT effectiveness. Therapy regimen, FBG level, and SP/M were independent prognostic factors for HLH survival.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Radiopharmaceuticals
/
Fluorodeoxyglucose F18
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Lymphohistiocytosis, Hemophagocytic
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Whole Body Imaging
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Positron Emission Tomography Computed Tomography
Type of study:
Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Limits:
Adolescent
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Adult
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Aged
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Female
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Humans
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Male
/
Middle aged
Language:
En
Journal:
Clin Radiol
Year:
2016
Document type:
Article