title: The clinical utility of FDG PET/CT among solid organ transplant recipients suspected of malignancy or infection.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Centre for Health and Infectious Disease Research (CHIP), Department of Infectious Diseases, Section 2100, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark. neval.ete.wareham@regionh.dk.
authors.forename: Neval E
authors.initials: NE
authors.lastname: Wareham
authors.affiliation: Centre for Health and Infectious Disease Research (CHIP), Department of Infectious Diseases, Section 2100, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark.
authors.forename: J D
authors.initials: JD
authors.lastname: Lundgren
authors.affiliation: Department of Haematology, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark.
authors.forename: C
authors.initials: C
authors.lastname: Da Cunha-Bang
authors.affiliation: Department of Cardiology, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark.
authors.forename: F
authors.initials: F
authors.lastname: Gustafsson
authors.affiliation: Department of Cardiology, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark.
authors.forename: M
authors.initials: M
authors.lastname: Iversen
authors.affiliation: Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark.
authors.forename: H H
authors.initials: HH
authors.lastname: Johannesen
authors.affiliation: Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark.
authors.forename: A
authors.initials: A
authors.lastname: Kjær
authors.affiliation: Department of Surgical Gastroenterology, Rigshospitalet, Blegdamsvek 9, 2100 Copenhagen Ø, Denmark.
authors.forename: A
authors.initials: A
authors.lastname: Rasmussen
authors.affiliation: Department of Haematology, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark.
authors.forename: H
authors.initials: H
authors.lastname: Sengeløv
authors.affiliation: Department of Nephrology, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark.
authors.forename: S S
authors.initials: SS
authors.lastname: Sørensen
authors.affiliation: Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark.
authors.forename: B M
authors.initials: BM
authors.lastname: Fischer
mesh_terms: D000328:Adult; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007239:Infections / Q000000981:diagnostic imaging* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000000981:diagnostic imaging* / Q000209:etiology; D016377:Organ Transplantation / Q000009:adverse effects*; D000072078:Positron Emission Tomography Computed Tomography; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D019275:Radiopharmaceuticals
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Diagnostic performance; Infection; Malignancy; PET/CT; Solid organ transplantation