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18F-FDG PET/CT and contrast-enhanced CT in the diagnosis of Castleman disease

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Japanese Journal of Radiology Aims and scope Submit manuscript

Abstract

Objective

Castleman disease (CD) is a rare group of lymphoproliferative disorders, which is easily confused with lymphoma or other solid tumors. Hence, this study aimed to investigate the diagnostic role of 18F-FDG PET/CT and contrast-enhanced CT (CECT) in patients with CD.

Methods

Clinicopathological characteristics, and 18F-FDG PET/CT and CECT findings and parameters were retrospectively reviewed in 32 patients with CD.

Results

These 32 patients (12 males, 20 females; median age, 41 years) consisted of 17 unicentric CD (UCD) patients and 15 multicentric CD (MCD) patients. Compared with MCD, UCD had a higher prevalence in female (82.4% vs. 40.0%) and hyaline vascular subtype (94.1% vs. 40.0%) (P < 0.05). FDG uptake was avid in all cases, including moderate uptake in 7 cases and intense uptake in 25 cases. The median SUVmax, SUVmean, MLV, and TLG of all cases were 4.4 (range, 1.4–23.6), 2.7 (range, 1.1–15.2), 26.6 (range, 4.8–393.0), and 78.8 (range, 9.4–1545.6), respectively. The lesions of 29 cases showed homogeneous enhancement, and marked enhancement was observed in 27 cases. 18F-FDG PET/CT corrected 6.3% CECT diagnoses, while CECT corrected 37.5% PET/CT diagnosis. The accuracy of combined PET/CT and CECT was superior to PET/CT or CECT alone (78.1%, 31.3%, and 62.5%). Besides, higher SUVmax and SUVmean were found in male subjects, MCD, and plasma cell subtype (P < 0.05), while higher MLV and TLG were observed in larger lesion size and volume (P < 0.05).

Conclusion

Castleman disease most commonly appears as marked and homogeneous enhancement meanwhile with moderate or intense FDG uptake. 18F-FDG PET/CT combined with CECT was the effectively diagnostic modality for CD. The glucose metabolism of CD was associated with gender, clinical classification, histopathological classification, and lesion size and volume.

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Funding

The work of Lei Jiang was supported by National Natural Science Foundation of China, 81971645, Guangdong Provincial People’s Hospital, KY0120211130, and Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, No. 2022B1212010011.

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Author notes

  1. Li He and Yu Chen have equally contributed to this work.

Authors and Affiliations

  1. PET Center, Department of Nuclear Medicine, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, 510080, China

    Li He, Xiaoyue Tan, Xiaolin Sun, Qing Zhang & Lei Jiang

  2. Department of Pathology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China

    Yu Chen

  3. Department of Radiology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China

    Haiying Luo

  4. Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China

    Lei Jiang

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  1. Li He
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Correspondence to Lei Jiang.

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He, L., Chen, Y., Tan, X. et al. 18F-FDG PET/CT and contrast-enhanced CT in the diagnosis of Castleman disease. Jpn J Radiol 41, 98–107 (2023). https://doi.org/10.1007/s11604-022-01318-6

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  • DOI: https://doi.org/10.1007/s11604-022-01318-6

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