ArticleEuropean journal of nuclear medicine and molecular imaging2026
Diagnostic impact of 18F-FDG PET/MRI over PET/CT in histiocytoses: a prospective comparative study.
Article in European journal of nuclear medicine and molecular imaging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeSystemic histiocytoses, including Erdheim-Chester disease, Langerhans cell histiocytosis, and Rosai-Dorfman disease, are rare multisystem disorders requiring accurate whole-body assessment for staging, treatment planning, and follow-up. While 18F-FDG PET/CT is the current reference imaging modality, PET/MRI may improve lesion detection and characterization owing to its superior soft-tissue contrast and lower radiation burden.
methodsIn this prospective single-centre study, 15 patients with systemic histiocytosis underwent sequential whole-body 18F-FDG PET/CT and PET/MRI after a single radiotracer injection. Images were independently assessed by two nuclear medicine physicians and one radiologist, with consensus evaluation of lesion detection, anatomical delineation, metabolic uptake, and disease extent.
resultsPET/CT and PET/MRI were concordant in 14/15 patients (93%). PET/MRI detected additional lesions or provided improved characterisation of known involved sites in 5/15 patients (33%), particularly in the central nervous system, lymph nodes, and bone marrow. Overall, 37 histiocytosis-attributed lesion sites were identified; PET/MRI detected all 37, whereas PET/CT detected 34. PET/MRI provided higher lesion delineation scores in 60% of cases and improved lesion characterisation in 33%. A brainstem lesion detected only by PET/MRI, in a patient with progressive cognitive deterioration, prompted re-evaluation of the therapeutic plan. PET/CT showed better performance for pulmonary lesion assessment.
conclusion18F-FDG PET/MRI provided incremental diagnostic value over PET/CT in systemic histiocytoses, particularly for lesion detection and characterization in anatomically complex regions. PET/MRI may be especially useful in patients requiring repeated imaging follow-up, although PET/CT remains advantageous for lung evaluation.
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