title: (18)F-FDG PET/CT in the management of patients with post-transplant lymphoproliferative disorder.
abstract: OBJECTIVE
  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 ((18)F-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 (18)F-FDG PET/CT in PTLD.
  
  
  METHODS
  We retrospectively reviewed the records of consecutive patients who had undergone (18)F-FDG PET/CT for evaluation of PTLD from January 2004 to June 2012 at our institution. (18)F-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 (18)F-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, (18)F-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.
  
  
  CONCLUSIONS
  (18)F-FDG PET/CT is beneficial in the diagnostic evaluation of patients with PTLD. (18)F-FDG PET/CT has the ability to detect occult lesions not identified on other imaging modalities, particularly extranodal lesions. In addition, (18)F-FDG PET/CT may predict the PTLD subtype, as the lesions with higher pathologic grade presented with significantly higher SUVmax compared with the less aggressive forms.
authors.affiliation: aDivision of Nuclear Medicine and Molecular Imaging, Stanford University Medical Center bLucile Packard Children's Hospital, Stanford, California, USA.
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Takehana
authors.forename: Clare J
authors.initials: CJ
authors.lastname: Twist
authors.forename: Camila
authors.initials: C
authors.lastname: Mosci
authors.forename: Andrew
authors.initials: A
authors.lastname: Quon
authors.forename: Erik
authors.initials: E
authors.lastname: Mittra
authors.forename: Andrei
authors.initials: A
authors.lastname: Iagaru
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007223:Infant; D008232:Lymphoproliferative Disorders / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014180:Transplantation / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D019788:Fluorodeoxyglucose F18