18F-FDG PET/CT in pediatric langerhans cell histiocytosis: relation to BRAFv600e mutation and risk stratification

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2025-08-13 DOI:10.1016/j.ejrad.2025.112361

Xueli Ji , Chao Li , Jinyu Gou , Xiaodong Wu , Yafu Yin , Hongliang Fu , Hui Wang , Suyun Chen

{"title":"18F-FDG PET/CT in pediatric langerhans cell histiocytosis: relation to BRAFv600e mutation and risk stratification","authors":"Xueli Ji , Chao Li , Jinyu Gou , Xiaodong Wu , Yafu Yin , Hongliang Fu , Hui Wang , Suyun Chen","doi":"10.1016/j.ejrad.2025.112361","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>BRAF<sup>V600E</sup> correlates with high-risk features and poor response to chemotherapy in pediatric Langerhans cell histiocytosis (LCH). This study aimed to evaluate the role of <sup>18</sup>F-FDG PET/CT in risk stratification and to explore the relationship between <sup>18</sup>F-FDG uptake and BRAF<sup>V600E</sup> mutation in LCH.</div></div><div><h3>Methods</h3><div>Pretreatment <sup>18</sup>F-FDG PET/CT scans from 114 newly diagnosed pediatric LCH were retrospectively analyzed. The associations between imaging findings and clinico-pathological parameters were investigated.</div></div><div><h3>Results</h3><div>PET/CT imaging led to a change of disease stratification in 47 (41.2 %) patients. The most common additional organs detected by PET/CT were lymph nodes and thymus. Elevated C-reactive protein (CRP) levels were associated with upstaging [Odds ratio (OR): 2.737, 95 % confidence interval (CI): 1.193–6.276, <em>p</em> = 0.017]. LCH lesions showed significantly higher SUVmax in patients with elevated CRP levels compared to those with normal levels (10.2 ± 4.7 vs. 7.3 ± 3.6, <em>p</em> = 0.001). BRAF<sup>V600E</sup> status was tested in 70 patients. Lower <sup>18</sup>F-FDG uptake (SUVmax: 8.2 ± 3.3 vs. 10.8 ± 4.9, <em>p</em> = 0.019) was observed in mutated-BRAF<sup>V600E</sup>. Multivariate logistic regression analysis revealed that SUVmax ≤ 10.6 (OR: 6.868, 95 % CI: 1.751–26.946, <em>p</em> = 0.006), absence of thymus involvement (OR: 11.849, 95 %CI: 1.907–73.635, <em>p</em> = 0.008) and CRP ≥ 15.0 mg/L (OR: 8.062, 95 % CI: 1.538–42.263, <em>p</em> = 0.014) significantly correlated with BRAF<sup>V600E</sup> mutation.</div></div><div><h3>Conclusions</h3><div>PET/CT identifies extra-osseous diseases in about 40% of patients, especially those with elevated CRP levels. Moreover, <sup>18</sup>F-FDG PET/CT findings were significantly associated with BRAF<sup>V600E</sup> mutation status, although wide CIs warrant cautious interpretation.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"191 ","pages":"Article 112361"},"PeriodicalIF":3.3000,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Radiology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0720048X25004474","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}

引用次数: 0

Abstract

Objective

BRAF^V600E correlates with high-risk features and poor response to chemotherapy in pediatric Langerhans cell histiocytosis (LCH). This study aimed to evaluate the role of ¹⁸F-FDG PET/CT in risk stratification and to explore the relationship between ¹⁸F-FDG uptake and BRAF^V600E mutation in LCH.

Methods

Pretreatment ¹⁸F-FDG PET/CT scans from 114 newly diagnosed pediatric LCH were retrospectively analyzed. The associations between imaging findings and clinico-pathological parameters were investigated.

Results

PET/CT imaging led to a change of disease stratification in 47 (41.2 %) patients. The most common additional organs detected by PET/CT were lymph nodes and thymus. Elevated C-reactive protein (CRP) levels were associated with upstaging [Odds ratio (OR): 2.737, 95 % confidence interval (CI): 1.193–6.276, p = 0.017]. LCH lesions showed significantly higher SUVmax in patients with elevated CRP levels compared to those with normal levels (10.2 ± 4.7 vs. 7.3 ± 3.6, p = 0.001). BRAF^V600E status was tested in 70 patients. Lower ¹⁸F-FDG uptake (SUVmax: 8.2 ± 3.3 vs. 10.8 ± 4.9, p = 0.019) was observed in mutated-BRAF^V600E. Multivariate logistic regression analysis revealed that SUVmax ≤ 10.6 (OR: 6.868, 95 % CI: 1.751–26.946, p = 0.006), absence of thymus involvement (OR: 11.849, 95 %CI: 1.907–73.635, p = 0.008) and CRP ≥ 15.0 mg/L (OR: 8.062, 95 % CI: 1.538–42.263, p = 0.014) significantly correlated with BRAF^V600E mutation.

Conclusions

PET/CT identifies extra-osseous diseases in about 40% of patients, especially those with elevated CRP levels. Moreover, ¹⁸F-FDG PET/CT findings were significantly associated with BRAF^V600E mutation status, although wide CIs warrant cautious interpretation.

查看原文本刊更多论文

儿童朗格汉斯细胞组织细胞增多症的18F-FDG PET/CT：与BRAFv600e突变和风险分层的关系

目的：brafv600e与儿童朗格汉斯细胞组织细胞增多症（LCH）的高危特征和化疗反应差相关。本研究旨在评估18F-FDG PET/CT在LCH风险分层中的作用，并探讨18F-FDG摄取与BRAFV600E突变之间的关系。方法回顾性分析114例新诊断的小儿LCH治疗前的18F-FDG PET/CT扫描。研究了影像学表现与临床病理参数之间的关系。结果在47例（41.2%）患者中，pet /CT成像导致疾病分层改变。PET/CT最常见的附加器官是淋巴结和胸腺。c反应蛋白（CRP）水平升高与占上风相关[优势比（OR）： 2.737, 95%可信区间（CI）： 1.193-6.276, p = 0.017]。与CRP水平正常的患者相比，LCH病变中CRP水平升高的患者SUVmax明显更高（10.2±4.7比7.3±3.6,p = 0.001）。在70例患者中检测BRAFV600E状态。突变brafv600e的18F-FDG摄取量较低（SUVmax: 8.2±3.3 vs 10.8±4.9,p = 0.019）。多因素logistic回归分析显示，SUVmax≤10.6 （OR: 6.868, 95% CI: 1.751 ~ 26.946, p = 0.006）、胸腺未受累（OR: 11.849, 95% CI: 1.907 ~ 73.635, p = 0.008）、CRP≥15.0 mg/L （OR: 8.062, 95% CI: 1.538 ~ 42.263, p = 0.014）与BRAFV600E突变显著相关。结论spet /CT诊断出骨外病变的比例约为40%，尤其是CRP水平升高的患者。此外，18F-FDG PET/CT结果与BRAFV600E突变状态显著相关，尽管广泛的CIs需要谨慎解释。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.