Objective To evaluate the value of 18-fluorine fluorodeoxyglucose positron emission tomography and computed tomography(18F-FDG PET/CT)in the diagnosis and prognosis of hemophagocytic syndrome.Methods Inpatient hemophagocytic lymphohistiocytosis(HLH)patients who underwent 18F-FDG PET/CT examination at the Department of Nuclear Medicine,Beijing Friendship Hospital,Capital Medical University from June 2016 to January 2019 were retrospectively selected.The clinical features,laboratory parameters and 18F-FDG PET/CT characters of patients with HLH before chemotherapy were summarized,retrospectively.Diagnostic performance of 18F-FDG PET for the de-tection of underlying lymphoma was evaluated,by calculating the sensitivity,specificity,positive predictive value and negative predictive value.Spearman correlation test was used to determine the correlations between 18F-FDG PET/CT and laboratory parameters.Survival analysis was per-formed by Kaplan-Meier method.The optimal cutoff value for predicting the prognosis of HLH patients using 18F-FDG PET/CT metabolic pa-rameters was determined using the receiver operating characteristic(ROC)curve.The prognostic significance of 18F-FDG PET/CT and laborato-ry parameters was evaluated by log-rank test and Cox proportional hazards regression model.Results The sensitivity,specificity,positive pre-dictive value and negative predictive value of 18F-FDG PET/CT for the diagnosis of lymphoma-associated HLH was 92.9％,80.8％,72.2％,95.5％,respectively.Standard uptake value(SUV)in the spleen was moderately positively associated with serum ferritin levels in HLH patients(r=0.418,P=0.007).A high level of bone marrow SUV and its ratio to the mediastinum suggested a shorter survival time for patients,and the optimal cutoff values were 4.98 and 3.60,respectively.Bone marrow SUV was the only independent risk factor for prognosis in patients with HLH.Conclusion 18 F-FDG PET/CT is useful in the early diagnosis of lymphoma-associated HLH,which can contribute to the formation of early therapy.There is a correlation between spleen SUV and serum ferritin levels.Bone marrow SUV may be an important predictor of prognosis in patients with HLH.
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