¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography in diagnosis of post-transplant lymphoproliferative disorder

Abstract

The aim of the present study was to investigate the role of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) in the diagnosis of post-transplant lymphoproliferative disorder (PTLD), a serious complication of solid organ and bone marrow transplant. Between January 2004 and January 2012, 40 patients (22 males; median age 52 ± 17.4 years, range 11-77 years) underwent (18)F-FDG PET/CT scans in our department for diagnostic evaluation of PTLD. Twenty-three (57.5%) patients had negative (18)F-FDG PET/CT and 17 (42.5%) had a positive examination. In five patients PET/CT revealed extranodal disease (adrenal, pleural, spleen, liver, lung, esophagus and bone involvement). On the basis of our results, (18)F-FDG PET/CT had a sensitivity of 88.2% (95% confidence interval [CI] 0.62-0.98), a specificity of 91.3% (CI 0.70-0.98), a positive predictive value of 88.2% (CI 0.62-0.98) and a negative predictive value of 91.3% (CI 0.70-0.98). The diagnostic performance of CT in patient-based analysis was: a sensitivity of 87.5% (CI 0.60-0.97), a specificity of 88.8% (CI 0.64-0.98), a positive predictive value of 87.5% (CI 0.60-0.97) and a negative predictive value of 88.8% (CI 0.64-0.98). PET/CT in five cases revealed more findings than CT, upstaging the disease, and revealed three extranodal findings, not visualized in conventional imaging. (18)F-FDG PET/CT plays a significant role in the setting of PTLD diagnosis, demonstrating its high accuracy in detecting PTLD.

18F-FDG PET/CT for the Diagnosis of Malignant and Infectious Complications After Solid Organ Transplantation

“…Compared to Graute's results, we obtained a higher specificity value, which is probably due to the systematic use of FDG PET/CT scanners but also to a possible bias related to the studied population. Panagiotidis et al [43] investigated the role of FDG PET/CT in the diagnosis of PTLD in 40 patients who had previously undergone solid organ or hematopoietic cell transplantation. In this study, FDG PET/CT's sensitivity and specificity were 88 % and 91 %, respectively.…”

Comprehensive review of post–organ transplant hematologic cancers

“…72 These techniques cannot separate polymorphic from monomorphic histological types of PTLDs/lymphomas. PET is considered slightly superior to CT scan, although both have high sensitivity and specificity.…”

“…PET is considered slightly superior to CT scan, although both have high sensitivity and specificity. 72 These techniques cannot separate polymorphic from monomorphic histological types of PTLDs/lymphomas. 73 PET scanning can be useful in monitoring the response to treatment.…”

The value of 18F‐FDG PET in pediatric patients with post‐transplant lymphoproliferative disorder at initial diagnosis

“…PET/CT incorporates both anatomic and functional imaging within a single imaging session, while permitting whole-body coverage, making it particularly useful for monitoring potentially widespread diseases. 18 F-FDG PET/CT has shown additional benefits in the initial staging of PTLD in adults (17)(18)(19)(20)(21)(22)(23), but its roles in altering staging and in providing additional prognostic information remain unclear (24). Less is known about the benefits of 18 F-FDG PET/CT in children, including in pediatric patients with PTLD (19,20,25).…”