<sup>18</sup>F-FDG PET/CT in the Diagnostic and Treatment Evaluation of Pediatric Posttransplant Lymphoproliferative Disorders

Jesus, Filipe Montes de; Glaudemans, Andor W J M; Tissing, Wim J. E.; Dierckx, Rudi; Rosati, S.; Diepstra, Arjan; Noordzij, Walter; Kwee, Thomas C.

doi:10.2967/jnumed.119.239624

Cited by 17 publications

(16 citation statements)

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“…But in one study, it was reported that false-negative results were confirmed in the Waldeyer's ring, cervical lymph nodes and small bowel being interpreted as physiological uptake in paediatric PTLD patients. 16 So we must persist with further investigation including tissue biopsy if there is a high clinical suspicion of PTLD. In our study, all the patients were diagnosed by histopathology and treated according to their individual pathological subtypes.…”

Section: Discussionmentioning

confidence: 99%

“…If hypermetabolic lymph nodes or extranodal masses are observed with PET‐CT, then pathological biopsy is needed to confirm the diagnosis. But in one study, it was reported that false‐negative results were confirmed in the Waldeyer's ring, cervical lymph nodes and small bowel being interpreted as physiological uptake in paediatric PTLD patients 16 . So we must persist with further investigation including tissue biopsy if there is a high clinical suspicion of PTLD.…”

Section: Discussionmentioning

confidence: 99%

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Post‐transplant lymphoproliferative disorder after paediatric liver transplantation

et al. 2020

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Objective The purpose of this study was to analyse the clinical and pathological characteristics, treatments and outcomes of post‐transplant lymphoproliferative disorder (PTLD) in paediatric liver transplant recipients. Method A retrospective analysis of records from nine paediatric liver transplant recipients with PTLD who were treated at our Liver Transplant Center over the period from June 2013 to August 2018. Result Of these nine patients, seven received liver transplantation in our centre and the remaining two patients at other hospitals. The overall incidence of PTLD in paediatric liver transplant recipients in our centre was 1.4% (7/485). The median onset of PTLD after liver transplantation was 11 months. Three cases were classified as infectious mononucleosis PTLD, one case was plasmacytic hyperplasia PTLD, one case was polymorphic PTLD and two cases were Burkitt lymphoma. One case showed diffuse large B‐cell lymphoma and one was classical Hodgkin lymphoma‐like PTLD. These patients presented with different clinical manifestations including fever, anaemia, diarrhoea, hypoproteinaemia, enlargement of lymph nodes, hepatosplenomegaly, jaundice, bowel obstruction and even intestinal perforation. Nine patients were positive for EBV‐DNA in serum. After diagnosis, immunosuppressants were reduced or discontinued in all cases. Eight patients received anti‐CD20 monoclonal antibody (Rituximab) therapy, four cases were treated with a combination of chemotherapy (R‐CHOP, ABVD, COPP/ABV) and one case was combined with radiotherapy. Two cases received surgical treatment due to bowel obstruction. Eight of these patients achieved a complete remission and remained healthy when assessed at the time of final follow‐up. One patient died as a result of PTLD progression. Conclusion PTLD is one of the most serious and fatal complications after liver transplantation. The definitive diagnosis requires histopathology. Treatment varies and basically includes immunosuppression reduction, anti‐CD20 antibody, surgery, radiotherapy and chemotherapy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Post‐transplant lymphoproliferative disorder after paediatric liver transplantation

et al. 2020

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“…84 6. FDG PET-CT is the recommended imaging modality to screen for PTLD in patients with symptoms and evidence of EBVpositivity (Grade B; SOR 2, moderate recommendation) [85][86][87] (Table 7).…”

Section: 2mentioning

confidence: 99%

Imaging of pediatric hematopoietic stem cell transplant recipients: A COG Diagnostic Imaging Committee/SPR Oncology Committee White Paper

Chan

Coblentz

Bhatia

et al. 2022

Pediatric Blood & Cancer

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Imaging in hematopoietic stem cell transplantation patients is not targeted at evaluating the transplant per se. Rather, imaging is largely confined to evaluating peri-procedural and post-procedural complications. Alternatively, imaging may be performed to establish a baseline study for comparison should the patient develop certain post-procedural complications. This article looks to describe the various imaging modalities available with recommendations for which imaging study should be performed in specific complications. We also provide select imaging protocols for different indications and modalities for the purpose of establishing a set minimal standard for imaging in these complex patients.

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“…A recent study involving 28 children with PTLD showed that 18 F-FDG PET/CT has a good positive predictive value (PPV) and specificity, but its sensitivity and negative predictive value (NPV) were poor. This may be because children grow and develop rapidly, and there are high metabolic regions such as the brain, kidneys, and heart that render 18 F-FDG PET/CT unable to detect PTLD that can be confirmed by histology in these regions (12). Studies have shown that the median peak standardized uptake value (SUVpeak) at the biopsy site of monomorphic PTLD is significantly higher than those of the polymorphic and non-destructive subtypes of PTLD.…”

Section: Introductionmentioning

confidence: 99%

The value of 18 F-FDG PET/CT quantitative indexes in the diagnosis of non-destructive PTLD after pediatric liver transplantation

Zhai

et al. 2022

Preprint

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Rationale: Post-transplant lymphoproliferative disease (PTLD) is a serious complication after pediatric liver transplantation (pLT), which may lead to death. F-FDG PET/CT is rarely considered in PTLD after pLT and lacks clear diagnostic guidelines, especially in the differential diagnosis of non-destructive PTLD. The aim of this study was to find a quantifiable F-FDG PET/CT index to identify non-destructive PTLD after pLT. Materials and Methods: This retrospective study collected the data of patients who underwent pLT, postoperative lymph node biopsy, and F-FDG PET/CT at Tianjin First Central Hospital from January 2014 to December 2021. Quantitative indexes were established using lymph node morphology and the maximum standardized uptake value (SUVmax). Results: A total of 83 patients met the inclusion criteria and were included in this retrospective study. To distinguish between PTLD-negative cases and non-destructive PTLD cases, according to the receiver operating characteristic curve, [the shortest diameter of the lymph node at the biopsy site (SDL)/the longest diameter of the lymph node at the biopsy site (LDL)]*[SUVmax at the biopsy site (SUVmaxBio)/SUVmax of the tonsils (SUVmaxTon)] had the maximum area under the curve (0.923; 95% confidence interval, 0.834–1.000), and the cut-off value was 0.264 according to the maximum value of Youden’s index. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 93.6%, 94.7%, 97.8%, 85.7%, and 93.9%, respectively. Conclusions: (SDL/LDL)*(SUVmaxBio/SUVmaxTon) has good sensitivity, specificity, positive predictive and negative predictive values, and accuracy, and can be used as a good quantitative index for the diagnosis of non-destructive PTLD.

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¹⁸F-FDG PET/CT in the Diagnostic and Treatment Evaluation of Pediatric Posttransplant Lymphoproliferative Disorders

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Cited by 17 publications

References 35 publications

Post‐transplant lymphoproliferative disorder after paediatric liver transplantation

Post‐transplant lymphoproliferative disorder after paediatric liver transplantation

Imaging of pediatric hematopoietic stem cell transplant recipients: A COG Diagnostic Imaging Committee/SPR Oncology Committee White Paper

The value of 18 F-FDG PET/CT quantitative indexes in the diagnosis of non-destructive PTLD after pediatric liver transplantation

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18F-FDG PET/CT in the Diagnostic and Treatment Evaluation of Pediatric Posttransplant Lymphoproliferative Disorders

Abstract: Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim.

Cited by 17 publications

References 35 publications

Post‐transplant lymphoproliferative disorder after paediatric liver transplantation

Post‐transplant lymphoproliferative disorder after paediatric liver transplantation

Imaging of pediatric hematopoietic stem cell transplant recipients: A COG Diagnostic Imaging Committee/SPR Oncology Committee White Paper

The value of 18 F-FDG PET/CT quantitative indexes in the diagnosis of non-destructive PTLD after pediatric liver transplantation

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¹⁸F-FDG PET/CT in the Diagnostic and Treatment Evaluation of Pediatric Posttransplant Lymphoproliferative Disorders