Whole-body MRI of Langerhans cell histiocytosis: comparison with radiography and bone scintigraphy.
BACKGROUND
In Langerhans cell histiocytosis (LCH) evaluation of the extent of disease is one of the major predictors of patient outcome. Historically this is undertaken using plain radiography and bone scintigraphy. Recently, whole-body (WB) MRI has been reported to be useful in detecting skeletal and extraskeletal metastases in both adults and children.


OBJECTIVE
To evaluate the usefulness of WB MRI in patients with LCH in comparison with plain radiography and bone scintigraphy.


METHODS
In nine children (1-7 years of age; mean 3.3 years) who had a pathological diagnosis of LCH and had either plain radiography or bone scintigraphy for comparison, 43 WB MR examinations were performed. Skeletal and extraskeletal lesions of the disease on WB MRI were compared with those on plain radiography and bone scintigraphy.


RESULTS
LCH showed unifocal single-system involvement in one patient, multifocal single-system involvement in three, and multifocal multisystem disease in five. WB MRI identified additional skeletal lesions in three (38%) of eight patients, compared with plain radiography, and in two (25%) of eight, compared with bone scintigraphy. WB MRI detected extraskeletal lesions of the disease in five (56%) of the nine patients exclusively, except for one patient whose lung lesions were also detected on plain radiography. In two patients, treatment was changed according to WB MRI findings.


CONCLUSIONS
WB MRI is a useful initial and follow-up diagnostic method to assess the extent of LCH because WB MRI not only identifies more skeletal lesions of the disease than do plain radiography and bone scintigraphy, but also detects extraskeletal lesions of the disease.
Goo
Hyun Woo
HW
Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 388-1 Poongnap-2 dong, Songpa-gu, Seoul, 138-736, South Korea. hwgoo@amc.seoul.kr
Yang
Dong Hyun
DH
Ra
Young Shin
YS
Song
Joon Sup
JS
Im
Ho Joon
HJ
Seo
Jong Jin
JJ
Ghim
Thad
T
Moon
Hyung Nam
HN
D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D005260:Female; D006646:Histiocytosis, Langerhans-Cell / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D011859:Radiography; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D051598:Whole Body Imaging
D003287:Contrast Media; D019275:Radiopharmaceuticals