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

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Neval E Wareham, J D Lundgren, C Da Cunha-Bang, F Gustafsson, M Iversen, H H Johannesen, A Kjær, A Rasmussen, H Sengeløv, S S Sørensen, B M Fischer

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.

Original languageEnglish
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume44
Issue number3
Pages (from-to)421-431
ISSN1619-7070
DOIs
Publication statusPublished - 2017

    Research areas

  • Adult, Female, Fluorodeoxyglucose F18, Humans, Infection/diagnostic imaging, Male, Middle Aged, Neoplasms/diagnostic imaging, Organ Transplantation/adverse effects, Positron Emission Tomography Computed Tomography, Postoperative Complications/diagnostic imaging, Radiopharmaceuticals

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