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Emerging role of 18F-FDG PET/CT in Castleman disease: a review

Benjamin Koa1,2, Austin J Borja1,3, Mahmoud Aly1

  • 1Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA.

Insights Into Imaging
|March 12, 2021
PubMed

Insights

Castleman disease (CD) is a rare blood disorder. Fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) shows promise for diagnosing CD subtypes and monitoring treatment effectiveness.

Area of Science:

  • Hematology
  • Nuclear Medicine
  • Radiology

Background:

  • Castleman disease (CD) encompasses rare hematologic disorders characterized by lymphadenopathy and diverse clinical manifestations.
  • CD is classified into unicentric (UCD) and multicentric (MCD) forms, with MCD further categorized by etiological drivers (HHV-8, POEMS, idiopathic).
  • Interleukin-6 is a key pro-inflammatory cytokine implicated in the pathogenesis of a subset of MCD patients.

Purpose of the Study:

  • To highlight the diagnostic and monitoring capabilities of FDG-PET/CT in Castleman disease.
  • To emphasize the need for improved characterization, earlier diagnosis, and accurate response evaluation tools for CD.
  • To suggest future research directions for FDG-PET/CT in CD management.

Main Methods:

  • Review of existing literature and clinical experience regarding FDG-PET/CT in Castleman disease.
  • Discussion of FDG-PET/CT's role in differentiating UCD from MCD.
  • Evaluation of FDG-PET/CT's utility in identifying MCD mimics and assessing treatment response.

Main Results:

  • FDG-PET/CT can aid in distinguishing between UCD and MCD.
  • This imaging modality can help identify neoplastic conditions that resemble MCD.
  • FDG-PET/CT is valuable for monitoring therapeutic responses in CD patients.

Conclusions:

  • FDG-PET/CT is a suitable tool for the characterization, diagnosis, and treatment monitoring of Castleman disease.
  • Further prospective studies are warranted to explore global disease assessment and dual time point imaging with FDG-PET/CT in CD.
  • Enhanced utilization of FDG-PET/CT can improve patient management and outcomes in Castleman disease.

Keywords:
Castleman diseaseFluorodeoxyglucose F18HIVInterleukin-6Positron emission tomography/computed tomography

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