Value of systemic PET/CT in the diagnosis and differential diagnosis of aplastic anemia.

The aim of the present study was to investigate the value of systemic [18F]fluorodeoxyglucose positron emission tomography (PET)/computed tomography (CT) in the diagnosis and differential diagnosis of aplastic anemia (AA). Systemic PET/CT imaging results of 24 patients diagnosed with AA in The First Affiliated Hospital of Sun Yat-Sen University between May 2011 and August 2014 were retrospectively analyzed and compared with results from healthy individuals and patients with acute leukemia (AL) or myelodysplastic syndrome (MDS) in the same period to summarize the PET/CT characteristics of patients with AA. Systemic PET/CT manifestations of the 24 patients with AA were classified into three types: Normal bone marrow metabolism, hypometabolism and hypometabolism complicated by focal hyperproliferation. Focal hyperproliferation was frequently identified in the vertebral body, breast bones and iliac bones. Bone marrow maximum standardized uptake values (SUV) of AA were associated, to certain extents, with the degree of proliferation and the bone marrow T/B cell ratio. The overall bone marrow SUV of AA were lower compared with those of healthy individuals and AL or patients with MDS, indicating hypometabolism. Considering the T/B cell ratio, systemic PET/CT manifestations of patients with AA are able to predict treatment responses to certain degrees. Systemic PET/CT is highly valuable in the diagnosis and differential diagnosis of AA, and may also indicate treatment responses.