PET-CT in the diagnostics and monitoring of pulmonary Langerhans cell histiocytosis


Authors: Z. Adam 1;  Z. Řehák 2;  R. Koukalová 2;  P. Szturz 1;  L. Pour 1;  M. Krejčí 1;  P. Krupa 3;  T. Nebeský 4;  Z. Adamová 5;  J. Mayer 1
Authors‘ workplace: Interní hematoonkologická klinika Lékařské fakulty MU a FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Jiří Mayer, CSc. 1;  Oddělení nukleární medicíny a pozitronové emisní tomografie Masarykova onkologického ústavu Brno, přednosta prim. MUDr. Karol Bolčák 2;  Klinika zobrazovacích metod Lékařské fakulty MU a FN u sv. Anny Brno, přednosta doc. MUDr. Petr Krupa, CSc. 3;  Radiologická klinika Lékařské fakulty MU a FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Vlastimil A. Válek, CSc. 4;  Chirurgické oddělení Nemocnice Vsetín, přednosta prim. MUDr. Jaroslav Sankot 5
Published in: Vnitř Lék 2010; 56(Supplementum 2): 123-130
Category: Langerhans cell histiocytosis and some other Hematology rare diseases

Overview

In a sample of 7 patients with pulmonary LCH, we monitored disease activity through repeated PET-CT examinations. The small size of LCH infiltrates in bronchioles (pulmonary nodules) precludes direct measurement of their activity. Therefore, SUVmax (maximum standardized uptake value) in the right lung and SUVmax in the liver were measured, as this was achievable with the available PET-CT software. The maximum activity measured in the right lung to maximum activity measured in the liver ratio was used to express the pulmonary activity of the Langerhans cell histiocytosis, i.e. the SUVmax pulmo/SUVmax liver index. In total, 25 measurements were performed in 7 patients with pulmonary LCH. This index values correlated with the development of the disease activity evaluated through overall patient status, HRCT imaging of the lungs and according to functional examination of the lungs. So far, this is a pilot project and the usefulness of this index in evaluating activity of the pulmonary LCH will require further verification.

Key words:
PET-CT – Langerhans cell histiocytosis – diabetes insipidus


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