Diagnostic Performance of FDG-PET/CT of Post-transplant Lymphoproliferative Disorder and Factors Affecting Diagnostic Yield

Overview

Journal Eur J Nucl Med Mol Imaging

Specialties Biophysics
Nuclear Medicine
Radiology

Date 2019 Aug 25

PMID 31444510

Citations 11

Authors

F M Montes de Jesus

T C Kwee

X U Kahle

M Nijland

T van Meerten

G Huls

R A J O Dierckx

S Rosati

A Diepstra

W van der Bij

E A M Verschuuren

A W J M Glaudemans

W Noordzij

Affiliations

Soon will be listed here.

Abstract

Purpose: Post-transplant lymphoproliferative disorder (PTLD) is a serious complication after solid organ and hematopoietic stem cell transplantation, requiring a timely and accurate diagnosis. In this study, we evaluated the diagnostic performance of FDG-PET/CT in patients with suspected PTLD and examined if lactate dehydrogenase (LDH) levels, Epstein-Barr virus (EBV) load, or timing of FDG-PET/CT relate to detection performance of FDG-PET/CT.

Methods: This retrospective study included 91 consecutive patients with clinical suspicion of PTLD and a total of 97 FDG-PET/CT scans within an 8-year period. Pathology reports and a 2-year follow-up were used as the reference standard. Diagnostic performance of FDG-PET/CT for detection of PTLD as well as logistic regression analysis for factors expected to affect diagnostic yield were assessed.

Results: The diagnosis of PTLD was established in 34 patients (35%). Fifty-seven FDG-PET/CT scans (59%) were true negative, 29 (30%) were true positive, 6 (6%) false positive, and 5 (5%) false negative. Sensitivity of FDG-PET/CT for the detection of PTLD was 85%, specificity 90%, positive predictive value 83%, and negative predictive value 92%, with good inter-observer variability (k = 0.78). Of the parameters hypothesized to be associated with a true positive FDG-PET/CT result for the diagnosis of PTLD, only LDH was statistically significant (OR 1.03, p = 0.04).

Conclusion: FDG-PET/CT has a good diagnostic performance in patients suspected of PTLD, with a good inter-observer agreement. Only LDH levels seemed to influence the detection performance of FDG-PET/CT. EBV-DNA load and timing of FDG-PET/CT after transplantation did not affect FDG-PET/CT diagnostic yield.

Citing Articles

The role of F-FDG PET/CT metabolic parameters in the differential diagnosis of post-transplant lymphoproliferative disorder after pediatric liver transplantation.

Wang C, Wang G, Wang W, Kan Y, Zhang M, Yang J Quant Imaging Med Surg. 2024; 14(2):1323-1334.

PMID: 38415126 PMC: 10895102. DOI: 10.21037/qims-23-1059.

Inferring the diagnostic potential of 18F-FDG-PET/CT in post-renal transplantation from a unique case harboring multiple rare complications.

Huang Z, Zou S, Liu Q, Qi W, Sharma A, Wang Y Front Med (Lausanne). 2024; 11:1353466.

PMID: 38371509 PMC: 10869483. DOI: 10.3389/fmed.2024.1353466.

Rare Case of Pediatric Post-transplant Lymphoproliferative Disorder Presenting With Pleural Masses Complicated by Pleural Effusions.

Nessim Kostandy E, Wan D, Imseis E ACG Case Rep J. 2023; 10(9):e01158.

PMID: 37753100 PMC: 10519540. DOI: 10.14309/crj.0000000000001158.

F-FDG PET/CT findings in a patient with blastic plasmacytoid dendritic cell neoplasm and post-transplant lymphoproliferative disorder after hematopoietic stem cell transplantation: a case report.

Chen J, Zhang X, Ma L, Gao Y, Fu Z, Liu M Front Med (Lausanne). 2023; 10:1258310.

PMID: 37663666 PMC: 10469918. DOI: 10.3389/fmed.2023.1258310.

F-FDG PET/CT imaging of posttransplant lymphoproliferative disorder following renal transplantation: Three clinical cases.

Pan B, Zhu X Heliyon. 2023; 9(4):e14746.

PMID: 37012908 PMC: 10066522. DOI: 10.1016/j.heliyon.2023.e14746.

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