18F-FDG PET/CT in the management of patients with post-transplant lymphoproliferative disorder

Christopher S. Takehana, Clare J. Twist, Camila Mosci, Andrew Quon, Erik Mittra, Andrei Iagaru

Research output: Contribution to journalArticle

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Abstract

Objectives: Post-transplant lymphoproliferative disorder (PTLD) is a rare but serious complication in transplant patients. Although fluorine-18 2-fluoro-2-deoxyglucose PET and computed tomography (18F-FDG PET/CT) has been used for the evaluation and management of patients with PTLD, its utility has yet to be documented. We were therefore prompted to review our experience with 18F-FDG PET/CT in PTLD. Materials and methods: We retrospectively reviewed the records of consecutive patients who had undergone 18F-FDG PET/CT for evaluation of PTLD from January 2004 to June 2012 at our institution. 18F-FDG PET/CT scans were compared with other imaging modalities performed concurrently. A chart review of pertinent clinical information was also conducted. Results: A total of 30 patients were identified (14 female and 16 male; 1.7-76.7 years of age, average: 23.8 years). Twenty-seven participants had biopsy-proven PTLD and another three had been treated for PTLD because of high clinical suspicion of disease and positive 18F-FDG PET/CT findings in the absence of histological diagnosis. Eighty-three percent of these PTLD patients had extranodal involvement. In 57% of the cases, 18F-FDG PET/CT detected occult lesions not identified on other imaging modalities or suggested PTLD in equivocal lesions. The more aggressive PTLD histological subtypes demonstrated higher SUVmax compared with the less aggressive subtypes. Conclusion: 18F-FDG PET/CT is beneficial in the diagnostic evaluation of patients with PTLD. 18F-FDG PET/CT has the ability to detect occult lesions not identified on other imaging modalities, particularly extranodal lesions. In addition, 18F-FDG PET/CT may predict the PTLD subtype, as the lesions with higher pathologic grade presented with significantly higher SUV max compared with the less aggressive forms.

Original languageEnglish (US)
Pages (from-to)276-281
Number of pages6
JournalNuclear Medicine Communications
Volume35
Issue number3
DOIs
StatePublished - Mar 1 2014
Externally publishedYes

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Lymphoproliferative Disorders
Fluorodeoxyglucose F18
Transplants
Fluorine
Tomography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

18F-FDG PET/CT in the management of patients with post-transplant lymphoproliferative disorder. / Takehana, Christopher S.; Twist, Clare J.; Mosci, Camila; Quon, Andrew; Mittra, Erik; Iagaru, Andrei.

In: Nuclear Medicine Communications, Vol. 35, No. 3, 01.03.2014, p. 276-281.

Research output: Contribution to journalArticle

Takehana, Christopher S. ; Twist, Clare J. ; Mosci, Camila ; Quon, Andrew ; Mittra, Erik ; Iagaru, Andrei. / 18F-FDG PET/CT in the management of patients with post-transplant lymphoproliferative disorder. In: Nuclear Medicine Communications. 2014 ; Vol. 35, No. 3. pp. 276-281.
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abstract = "Objectives: Post-transplant lymphoproliferative disorder (PTLD) is a rare but serious complication in transplant patients. Although fluorine-18 2-fluoro-2-deoxyglucose PET and computed tomography (18F-FDG PET/CT) has been used for the evaluation and management of patients with PTLD, its utility has yet to be documented. We were therefore prompted to review our experience with 18F-FDG PET/CT in PTLD. Materials and methods: We retrospectively reviewed the records of consecutive patients who had undergone 18F-FDG PET/CT for evaluation of PTLD from January 2004 to June 2012 at our institution. 18F-FDG PET/CT scans were compared with other imaging modalities performed concurrently. A chart review of pertinent clinical information was also conducted. Results: A total of 30 patients were identified (14 female and 16 male; 1.7-76.7 years of age, average: 23.8 years). Twenty-seven participants had biopsy-proven PTLD and another three had been treated for PTLD because of high clinical suspicion of disease and positive 18F-FDG PET/CT findings in the absence of histological diagnosis. Eighty-three percent of these PTLD patients had extranodal involvement. In 57{\%} of the cases, 18F-FDG PET/CT detected occult lesions not identified on other imaging modalities or suggested PTLD in equivocal lesions. The more aggressive PTLD histological subtypes demonstrated higher SUVmax compared with the less aggressive subtypes. Conclusion: 18F-FDG PET/CT is beneficial in the diagnostic evaluation of patients with PTLD. 18F-FDG PET/CT has the ability to detect occult lesions not identified on other imaging modalities, particularly extranodal lesions. In addition, 18F-FDG PET/CT may predict the PTLD subtype, as the lesions with higher pathologic grade presented with significantly higher SUV max compared with the less aggressive forms.",
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