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Abstract

We aimed to evaluate the diagnostic performance of 18F-FDG PET/CT for the detection of posttransplantation lymphoproliferative disorder (PTLD) in a pediatric population and explore its feasibility during response assessment. Methods: This retrospective study included 28 pediatric transplant recipients who underwent a total of 32 18F-FDG PET/CT scans due to clinical suspicion of PTLD within an 8-y period. Pathology reports and 2 y of follow-up were used as the reference standard. Twenty-one response assessment 18F-FDG PET/CT scans were reevaluated according to the Lugano criteria. Results: The diagnosis of PTLD was established in 14 patients (49%). Sensitivity, specificity, positive predictive value, and negative predictive value of 18F-FDG PET/CT for the detection of PTLD in children with a clinical suspicion of this disease were 50% (7/14), 100% (18/18), 100% (7/7), and 72% (18/25), respectively. False-negative results occurred in patients with PTLD in the Waldeyer's ring, cervical lymph nodes, or small bowel with either nondestructive or polymorphic PTLD. Two of 5 interim 18F-FDG PET/CT scans and 3 of 9 end-of-treatment 18F-FDG PET/CT scans were false-positive. Conclusion:18F-FDG PET/CT had good specificity and positive predictive value but low to moderate sensitivity and negative predictive value for the detection of PTLD in a 28-pediatric-patient cohort with a clinical suspicion of this disease. False-negative results were confirmed in the Waldeyer's ring, cervical lymph nodes, and small bowel with either nondestructive or polymorphic PTLD subtypes. 18F-FDG PET/CT appears to have a limited role in the response assessment setting of pediatric PTLD, given the observed high proportions of false-positives both at interim and at end-of-treatment evaluations.

Original languageEnglish
Pages (from-to)1307-1313
Number of pages7
JournalJournal of Nuclear Medicine
Volume61
Issue number9
Early online date31-Jan-2020
DOIs
Publication statusPublished - 1-Sep-2020

Keywords

  • posttransplant lymphoproliferative disorder
  • F-18-fluoro-D-deoxyglucose PET
  • F-18-FDG PET/CT
  • diagnosis
  • pediatric
  • POSITRON-EMISSION-TOMOGRAPHY
  • ORGAN TRANSPLANT RECIPIENTS
  • B-CELL LYMPHOMA
  • SOLID-ORGAN
  • FDG-PET
  • DISEASE
  • MANAGEMENT
  • PTLD
  • CHILDREN
  • SURVIVAL
  • 18F-fluoro-d-deoxyglucose PET
  • 18F-FDG PET/CT

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