title: The role of18F-FDG PET/CT in the management of patients with secondary haemophagocytic lymphohistiocytosis.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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 spleen:mediastinum ratio (SP/M) (HR=7.44, p=0.006) were independent prognostic factors for survival.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Nuclear Medicine, China-Japan Friendship Hospital, Beijing, PR China.
authors.forename: Y
authors.initials: Y
authors.lastname: Zheng
authors.affiliation: Department of Nuclear Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, PR China.
authors.forename: G
authors.initials: G
authors.lastname: Hu
authors.affiliation: Department of Nuclear Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, PR China.
authors.forename: Y
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Nuclear Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, PR China.
authors.forename: Y
authors.initials: Y
authors.lastname: Ma
authors.affiliation: Department of Nuclear Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, PR China.
authors.forename: Y
authors.initials: Y
authors.lastname: Dang
authors.affiliation: Department of Nuclear Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, PR China.
authors.forename: F
authors.initials: F
authors.lastname: Li
authors.affiliation: Department of Nuclear Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, PR China.
authors.forename: H
authors.initials: H
authors.lastname: Xing
authors.affiliation: Department of Nuclear Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, PR China.
authors.forename: T
authors.initials: T
authors.lastname: Wang
authors.affiliation: Department of Nuclear Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, PR China. Electronic address: Huoli@pumch.cn.
authors.forename: L
authors.initials: L
authors.lastname: Huo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D051359:Lymphohistiocytosis, Hemophagocytic / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D011379:Prognosis; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016019:Survival Analysis; D051598:Whole Body Imaging / Q000379:methods*; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18