The Value of Diffuse Splenic and Hepatic ¹⁸F-FDG Uptake on PET/CT in Diagnosing Patients with Anemia

Anemia is a disease with a negative impact on the progression and prognosis of tumor diseases and usually diagnosed by blood tests. Imaging examination has been used as an alternative method to diagnose anemia in addition to blood tests for patients who cannot tolerate blood draw (such as those with severe coagulopathy). The purpose of this study was to investigate the role of diffuse splenic and hepatic ¹⁸F-FDG uptake on PET/CT in anemia, by analyzing the correlation between the hemoglobin level and diffuse splenic and hepatic as well as marrow ¹⁸F-FDG uptakes in patients who underwent PET/CT.

Forty four patients who underwent a peripheral blood examination within 2 days of a ¹⁸F-FDG-PET/CT in our hospital from March 2020 to March 2021 were included. The standardized uptake value (SUV) of the spleen, liver, and marrow were measured, including the maximum value (SUVmax) and the mean value (SUVmean), and the CT value (CTV) of the left ventricular (LV) cavity was measured, including the maximum value (CTVmax) and the mean value (CTVmean). The relation between these measurements and the blood hemoglobin level were analyzed.

Our analysis revealed that the hemoglobin level was negatively correlated with the SUVmax of the spleen (P ≤ 0.01, R = -0.385), SUVmean of the spleen (P ≤ 0.01, R = -0.395), SUVmax of the liver (P ≤ 0.05, R = -0.365), and SUVmean of the liver (P ≤ 0.05, R = -0.315). The hemoglobin level was positively correlated with CTVmax of the LV cavity (P ≤ 0.05, R = 0.33) and CTVmean of the LV cavity (P ≤ 0.05, R = 0.382), while no statistically significant correlation between the hemoglobin level and the SUV of marrow was observed (P > 0.05).

Our study revealed a negative correlation between the hemoglobin level and spleen SUV as well as liver SUV, and a positive correlation between the hemoglobin level and CTV of the LV cavity. These findings may provide potential indictors for the imaging diagnosis of anemia, which has important clinical significance in certain clinical scenarios including the evaluation of anemia status in patients who cannot tolerate blood draws and retrospective clinical studies based on patient imaging data.