PT  - JOURNAL ARTICLE
AU  - Filipe M. Montes de Jesus
AU  - Andor W.J.M. Glaudemans
AU  - Wim J. Tissing
AU  - Rudi A.J.O. Dierckx
AU  - Stefano Rosati
AU  - Arjan Diepstra
AU  - Walter Noordzij
AU  - Thomas C. Kwee
TI  - <sup>18</sup>F-FDG PET/CT in the Diagnostic and Treatment Evaluation of Pediatric Posttransplant Lymphoproliferative Disorders
AID  - 10.2967/jnumed.119.239624
DP  - 2020 Sep 01
TA  - Journal of Nuclear Medicine
PG  - 1307--1313
VI  - 61
IP  - 9
4099  - http://jnm.snmjournals.org/content/61/9/1307.short
4100  - http://jnm.snmjournals.org/content/61/9/1307.full
SO  - J Nucl Med2020 Sep 01; 61
AB  - We aimed to evaluate the diagnostic performance of 18F-FDG PET/CT for the detection of posttransplantation lymphoproliferative disorder (PTLD) in a pediatric population and explore its feasibility during response assessment. Methods: This retrospective study included 28 pediatric transplant recipients who underwent a total of 32 18F-FDG PET/CT scans due to clinical suspicion of PTLD within an 8-y period. Pathology reports and 2 y of follow-up were used as the reference standard. Twenty-one response assessment 18F-FDG PET/CT scans were reevaluated according to the Lugano criteria. Results: The diagnosis of PTLD was established in 14 patients (49%). Sensitivity, specificity, positive predictive value, and negative predictive value of 18F-FDG PET/CT for the detection of PTLD in children with a clinical suspicion of this disease were 50% (7/14), 100% (18/18), 100% (7/7), and 72% (18/25), respectively. False-negative results occurred in patients with PTLD in the Waldeyer’s ring, cervical lymph nodes, or small bowel with either nondestructive or polymorphic PTLD. Two of 5 interim 18F-FDG PET/CT scans and 3 of 9 end-of-treatment 18F-FDG PET/CT scans were false-positive. Conclusion: 18F-FDG PET/CT had good specificity and positive predictive value but low to moderate sensitivity and negative predictive value for the detection of PTLD in a 28-pediatric-patient cohort with a clinical suspicion of this disease. False-negative results were confirmed in the Waldeyer’s ring, cervical lymph nodes, and small bowel with either nondestructive or polymorphic PTLD subtypes. 18F-FDG PET/CT appears to have a limited role in the response assessment setting of pediatric PTLD, given the observed high proportions of false-positives both at interim and at end-of-treatment evaluations.