RADIOGRAPHIC SKELETAL SURVEY AND RADIONUCLIDE BONE-SCAN IN LANGERHANSCELL HISTIOCYTOSIS OF BONE

Background. The lack of a consensus in the literature on the imaging s trategy in Langerhans cell histiocytosis (LCH) bone lesions in childho od. Objective. To evaluate the relative value of radionuclide bone sca n (RBS) and radiographic skeletal survey (RSS) in the detection of LCH bone lesions, both in the initial work-up of the disease and during t he follow-up period. Materials and methods. Ten children with bone les ions evaluated by means of RSS and RBS in a retrospective study (1984- 1993). Results. Fifty radiologically and/or scintigraphically abnormal foci were detected: 27 anomalies in the initial work-up (12 by both R SS and RBS, 8 by RSS only and 7 by RBS only) and 23 additional anomali es during follow-up (10 by both RSS and RBS, 10 by RSS only and 3 by R BS only). RSS+/RBS- lesions (n = 18) are more frequently encountered i n the skull (P = 0.038), and more fre quently lack radiologic signs of osteoblastic activity (P = 0.020), than RSS+/RBS+ lesions (n = 22). R SS-/RBS+ abnormalities (n = 10) were most frequently insignificant. Co nclusion. In the initial work-up both RSS and RBS should be carried ou t, while in the follow-up only RSS should be performed.