title: Fluorodeoxyglucose F(18) Positron Emission Tomography Coupled With Computed Tomography in Suspected Acute Renal Allograft Rejection.
abstract: Management of kidney transplant recipients (KTRs) with suspected acute rejection (AR) ultimately relies on kidney biopsy; however, noninvasive tests predicting nonrejection would help avoid unnecessary biopsy. AR involves recruitment of leukocytes avid for fluorodeoxyglucose F(18) ((18) F-FDG), thus (18) F-FDG positron emission tomography (PET) coupled with computed tomography (CT) may noninvasively distinguish nonrejection from AR. From January 2013 to February 2015, we prospectively performed 32 (18) F-FDG PET/CT scans in 31 adult KTRs with suspected AR who underwent transplant biopsy. Biopsies were categorized into four groups: normal (n = 8), borderline (n = 10), AR (n = 8), or other (n = 6, including 3 with polyoma BK nephropathy). Estimated GFR was comparable in all groups. PET/CT was performed 201 ± 18 minutes after administration of 3.2 ± 0.2 MBq/kg of (18) F-FDG, before any immunosuppression change. Mean standard uptake values (SUVs) of both upper and lower renal poles were measured. Mean SUVs reached 1.5 ± 0.2, 1.6 ± 0.3, 2.9 ± 0.8, and 2.2 ± 1.2 for the normal, borderline, AR, and other groups, respectively. One-way analysis of variance demonstrated a significant difference of mean SUVs among groups. A positive correlation between mean SUV and acute composite Banff score was found, with r(2)  = 0.49. The area under the receiver operating characteristic curve was 0.93, with 100% sensitivity and 50% specificity using a mean SUV threshold of 1.6. In conclusion, (18) F-FDG PET/CT may help noninvasively prevent avoidable transplant biopsies in KTRs with suspected AR.
authors: Division of Nuclear Medicine, Department of Medical Physics, University of Liège Hospital, Liège, Belgium.
authors: P
authors: P
authors: Lovinfosse
authors: Division of Nephrology, Department of Internal Medicine, University of Liège Hospital, Liège, Belgium.
authors: L
authors: L
authors: Weekers
authors: Division of Nephrology, Department of Internal Medicine, University of Liège Hospital, Liège, Belgium.
authors: C
authors: C
authors: Bonvoisin
authors: Division of Nephrology, Department of Internal Medicine, University of Liège Hospital, Liège, Belgium.|Division of Renal Pathology, Unilab, University of Liège Hospital, Liège, Belgium.
authors: C
authors: C
authors: Bovy
authors: Division of Nephrology, Department of Internal Medicine, University of Liège Hospital, Liège, Belgium.|Division of Renal Pathology, Unilab, University of Liège Hospital, Liège, Belgium.
authors: S
authors: S
authors: Grosch
authors: Division of Nephrology, Department of Internal Medicine, University of Liège Hospital, Liège, Belgium.|Groupe Interdisciplinaire de Génoprotéomique Appliquée, Cardiovascular Sciences, University of Liège, Liège, Belgium.
authors: J-M
authors: JM
authors: Krzesinski
authors: Division of Nuclear Medicine, Department of Medical Physics, University of Liège Hospital, Liège, Belgium.
authors: R
authors: R
authors: Hustinx
authors: Division of Nephrology, Department of Internal Medicine, University of Liège Hospital, Liège, Belgium.|Groupe Interdisciplinaire de Génoprotéomique Appliquée, Cardiovascular Sciences, University of Liège, Liège, Belgium.
authors: F
authors: F
authors: Jouret
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000008:administration & dosage*; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000000981:diagnostic imaging* / Q000473:pathology; D006085:Graft Survival; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery; D007677:Kidney Function Tests; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D010865:Pilot Projects; D049268:Positron-Emission Tomography / Q000379:methods; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D019275:Radiopharmaceuticals / Q000008:administration & dosage*; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000379:methods; D014184:Transplantation, Homologous; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18