Diagnostic role of whole-body [18F]-FDG positron emission tomography in patients with symptoms suspicious for malignancy after heart transplantation

Graute, Vera; Jansen, Nathalie; Sohn, Hae-Young; Becker, Alexander; Klein, Barbara E.K.; Schmid, Irene; Greil, Sabine; Lehner, S.; Bartenstein, Peter; Pfluger, Thomas; Hacker, Marcus

doi:10.1016/j.healun.2012.05.011

Cited by 12 publications

(10 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Urinary FDG excretion and the physiological and heterogeneous intestinal FDG uptake probably reduced the sensitivity of FDG PET/CT for detecting pyelonephritis and GVH reactions. Concerning septicemia, other authors reported false-negative results in this clinical situation [26]. Although interesting results were obtained from an important cohort of kidney, lung and heart-transplanted patients, this study has several limitations such as its retrospective design and the lack of histopathologic confirmation for all lesions.…”

Section: Discussionmentioning

confidence: 82%

“…Moreover, the evolution of radiotracer uptake intensity reflects the efficacy of treatment, permitting either a better modulation of the drug dosage or a radical modification of the therapeutic strategy. Graute et al [26] retrospectively evaluated the diagnostic role of FDG PET or FDG PET/CT in 17 patients with symptoms suspicious of malignancy after heart transplantation. They reported a global accuracy of 71 %, ranging from 43 % to 90 % in patients examined by FDG PET or FDG PET/CT, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Finally, FDG PET/CT plays a role in assessing treatment efficacy in neoplastic [21] and selected non-neoplastic conditions [22,23], leading to the detection of residual tumoral or inflammatory localizations. Accordingly, FDG PET/CT may represent an interesting technique in the post-transplantation follow-up in patients with inflammatory syndrome of unknown origin and unspecific clinical symptomatology [2,[24][25][26][27].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

18F-FDG PET/CT for the Diagnosis of Malignant and Infectious Complications After Solid Organ Transplantation

Muller

Kessler

Caillard

et al. 2016

Nucl Med Mol Imaging

View full text Add to dashboard Cite

Purpose Infection and malignancy represent two common complications after solid organ transplantation, which are often characterized by poorly specific clinical symptomatology. Herein, we have evaluated the role of 18 F-fluoro-2-deoxy-Dglucose (FDG) positron emission tomography/computed tomography (PET/CT) in this clinical setting. Methods Fifty-eight consecutive patients who underwent FDG PET/CT after kidney, lung or heart transplantation were included in this retrospective analysis. Twelve patients underwent FDG PET/CT to strengthen or confirm a diagnostic suspicion of malignancies. The remaining 46 patients presented with unexplained inflammatory syndrome, fever of unknown origin (FUO), CMV or EBV seroconversion during post-transplant follow-up without conclusive conventional imaging. FDG PET/CT results were compared to histology or to the finding obtained during a clinical/imaging follow-up period of at least 6 months after PET/CT study. Results Positive FDG PET/CT results were obtained in 18 (31 %) patients. In the remaining 40 (69 %) cases, FDG PET/CT was negative, showing exclusively a physiological radiotracer distribution. On the basis of a patient-based analysis, FDG PET/CT's sensitivity, specificity, PPV and NPV were respectively 78 %, 90 %, 78 % and 90 %, with a global accuracy of 86 %. FDG PET/CT was true positive in 14 patients with bacterial pneumonias (n = 4), pulmonary fungal infection (n = 1), histoplasmosis (n = 1), cutaneous abscess (n = 1), inflammatory disorder (sacroiliitis) (n = 1), lymphoma (n = 3) and NSCLC (n = 3). On the other hand, FDG PET/CT failed to detect lung bronchoalveolar adenocarcinoma, septicemia, endocarditis and graft-versus-host disease (GVHD), respectively, in four patients. FDG PET/CT contributed to adjusting the patient therapeutic strategy in 40 % of cases. Conclusions FDG PET/CT emerges as a valuable technique to manage complications in the post-transplantation period. FDG PET/CT should be considered in patients with severe unexplained inflammatory syndrome or FUO and inconclusive conventional imaging or to discriminate active from silent lesions previously detected by conventional imaging particularly when malignancy is suspected.

show abstract

Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

18F-FDG PET/CT for the Diagnosis of Malignant and Infectious Complications After Solid Organ Transplantation

Muller

Kessler

Caillard

et al. 2016

Nucl Med Mol Imaging

View full text Add to dashboard Cite

show abstract

“…[15][16][17][18][19][20] Although specificity is limited, Chan et al 15 showed an improvement in MFR after treatment of acute cellular rejection. Whether similar findings are true in antibody-mediated rejection remains to be determined.…”

Section: Givertz Cardiac Allograft Vasculopathy and Pet 859mentioning

confidence: 99%

“…Whole-body 18-fluorodeoxyglucose PET imaging has been used successfully to diagnose infection and malignancy in patients with nonspecific unexplained symptoms. 17 Other complications after heart transplant, including dyslipidemia and myocardial infarction, may also be alleviated by therapies guided by PET. 18,20 Beyond PET imaging, newer techniques for diagnosis and prognosis of CAV are emerging.…”

Section: Givertz Cardiac Allograft Vasculopathy and Pet 859mentioning

confidence: 99%