Clinical value of 18F-FDG PET/CT in the management of Castleman's disease / 中华核医学与分子影像杂志

ABSTRACT

Objective To assess the value of 18F-FDG PET/CT in clinical classification,monitoring of chemotherapeutic response and surveillance of histopathological transformation of Castleman's disease (CD).Methods Fourteen pathologically diagnosed CD patients (7 males,7 females; mean age(45.64±14.30) years) were retrospectively reviewed.18F-FDG PET/CT was performed before chemotherapy in all patients and 4 of 14 patients were reexamined after the treatment.The study parameters included histopathological results,sites,number and highest SUVmax of the lesions.Mann-Whitney and Kruskal-Wallis tests were used for data analysis.Results Of all the 12 patients without histopathological transformation,one or more enlarged and metabolically active lymph nodes were found in each patient (SUVmax =3.94± 1.44,range1.9-6.8),including 2 unicentric CD (UCD) and 10 multicentric CD (MCD).There was no statistically significant difference of SUVmam between UCD and MCD (4.55±3.18 vs 3.82±1.14; Z=0.22,P＞0.05).There was also no significant difference of SUVmax among different pathological types (hyaline-vascular CD (4/12)3.56±0.96,plasma cell CD (6/12)4.73±1.41,mixed CD (2/12)2.30±0.57; x2 =4.74,P＞0.05).For the 4 patients with follow-up PET/CT after chemotherapy,the lesion activity was normalized in 3 patients and clearly reduced in 1 patient.The SUVmax of 2 patients with histopathological transformation (10.85±2.05) was significantly higher than that without transformation (3.94± 1.44; Z=-2.19,P＜0.05).Conclusion 18F-FDG PET/CT may play an important role in clinical classification,monitoring of chemotherapeutic response and surveillance of histopathological transformation of CD.