The clinical utility of FDG PET/CT among solid organ transplant recipients suspected of malignancy or infection

TY - JOUR

T1 - The clinical utility of FDG PET/CT among solid organ transplant recipients suspected of malignancy or infection

AU - Wareham, Neval E

AU - Lundgren, J D

AU - Da Cunha-Bang, C

AU - Gustafsson, F

AU - Iversen, M

AU - Johannesen, H H

AU - Kjær, A

AU - Rasmussen, A

AU - Sengeløv, H

AU - Sørensen, S S

AU - Fischer, B M

PY - 2017/3/1

Y1 - 2017/3/1

N2 - PURPOSE: Solid organ transplant (SOT) recipients are at high risk of developing infections and malignancies.18F-FDG PET/CT may enable timely detection of these diseases and help to ensure early intervention. We aimed to describe the clinical utility of FDG PET/CT in consecutive, diagnostic unresolved SOT recipients transplanted from January 2004 to May 2015.METHODS: Recipients with a post-transplant FDG PET/CT performed as part of diagnostic work-up were included. Detailed chart reviews were done to extract relevant clinical information and determine the final diagnosis related to the FDG PET/CT. Based on á priori defined criteria and the final diagnosis, results from each scan were classified as true or false, and diagnostic values determined.RESULTS: Among the 1,814 recipients in the cohort, 145 had an FDG PET/CT performed; 122 under the indication of diagnostically unresolved symptoms with a suspicion of malignancy or infection. The remaining (N = 23) had an FDG PET/CT to follow-up on a known disease or to stage a known malignancy. The 122 recipients underwent a total of 133 FDG PET/CT scans performed for a suspected malignancy (66 %) or an infection (34 %). Sensitivity, specificity, and positive and negative predictive values of the FDG PET/CT in diagnosing these conditions were 97, 84, 87, and 96 %, respectively.CONCLUSION: FDG PET/CT is an accurate diagnostic tool for the work-up of diagnostic unresolved SOT recipients suspected of malignancy or infection. The high sensitivity and NPV underlines the potential usefulness of PET/CT for excluding malignancy or focal infections in this often complex clinical situation.

AB - PURPOSE: Solid organ transplant (SOT) recipients are at high risk of developing infections and malignancies.18F-FDG PET/CT may enable timely detection of these diseases and help to ensure early intervention. We aimed to describe the clinical utility of FDG PET/CT in consecutive, diagnostic unresolved SOT recipients transplanted from January 2004 to May 2015.METHODS: Recipients with a post-transplant FDG PET/CT performed as part of diagnostic work-up were included. Detailed chart reviews were done to extract relevant clinical information and determine the final diagnosis related to the FDG PET/CT. Based on á priori defined criteria and the final diagnosis, results from each scan were classified as true or false, and diagnostic values determined.RESULTS: Among the 1,814 recipients in the cohort, 145 had an FDG PET/CT performed; 122 under the indication of diagnostically unresolved symptoms with a suspicion of malignancy or infection. The remaining (N = 23) had an FDG PET/CT to follow-up on a known disease or to stage a known malignancy. The 122 recipients underwent a total of 133 FDG PET/CT scans performed for a suspected malignancy (66 %) or an infection (34 %). Sensitivity, specificity, and positive and negative predictive values of the FDG PET/CT in diagnosing these conditions were 97, 84, 87, and 96 %, respectively.CONCLUSION: FDG PET/CT is an accurate diagnostic tool for the work-up of diagnostic unresolved SOT recipients suspected of malignancy or infection. The high sensitivity and NPV underlines the potential usefulness of PET/CT for excluding malignancy or focal infections in this often complex clinical situation.

KW - Adult

KW - Female

KW - Fluorodeoxyglucose F18

KW - Humans

KW - Infection/diagnostic imaging

KW - Male

KW - Middle Aged

KW - Neoplasms/diagnostic imaging

KW - Organ Transplantation/adverse effects

KW - Positron Emission Tomography Computed Tomography

KW - Postoperative Complications/diagnostic imaging

KW - Radiopharmaceuticals

U2 - 10.1007/s00259-016-3564-5

DO - 10.1007/s00259-016-3564-5

M3 - Journal article

C2 - 27838763

SN - 1619-7070

VL - 44

SP - 421

EP - 431

JO - European Journal of Nuclear Medicine and Molecular Imaging

JF - European Journal of Nuclear Medicine and Molecular Imaging

IS - 3

ER -