| Diagnostic role of whole-body [(18)F]-FDG positron emission tomography in patients with symptoms suspicious for malignancy after heart transplantation. | |
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MedLine Citation:
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PMID: 22766023 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Increased rates of malignancies and infections occur in transplant patients under immunosuppression, but the resultant clinical symptoms, and results of physical examination, chest X-ray, abdominal ultrasonography and laboratory findings are frequently difficult to interpret or inconclusive. The aim of the present study was to investigate the usefulness of whole-body [(18)F]-FDG PET for investigation of heart transplant patients suffering from suspicious symptoms, with a previously ambiguous diagnosis. METHODS: Seventeen consecutive patients (8 women; 48 ± 22 years) with non-specific symptoms (lymphadenopathy, fever of unknown origin or recurrent febrile temperatures, weight loss, abdominal pain, night sweating, cough or generally reduced physical condition) were evaluated retrospectively. All patients underwent whole-body [(18)F]-FDG examinations by PET (7 patients) or PET/CT (10 patients) at 8 ± 6 (range 0.1 to 21) years after orthotopic heart transplantation (OHT). During a follow-up of 28 ± 25 months, results of bone marrow biopsies, and histologic and/or microbiologic findings were registered and retrospectively compared with the PET results. RESULTS: PET revealed the cause of non-specific symptoms in 9 of 17 patients; there were 5 cases of lymphoproliferative disease (PTLD), 2 carcinomas and 2 cases of infection. Four patients were rated false positive, 1 patient false negative and 3 patients were correctly rated as negative. Sensitivity, specificity and positive and negative predictive values were 0.90, 0.43, 0.69 and 0.75, respectively, giving an overall diagnostic accuracy of 0.71. CONCLUSIONS: A non-invasive strategy of using whole-body [(18)F]-FDG PET or PET/CT in heart transplant recipients with non-specific unexplained symptoms may offer diagnostic stratification for malignancy and infections with a high sensitivity and modest diagnostic accuracy. These findings require prospective confirmation. |
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Authors:
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Vera Graute; Nathalie Jansen; Hae-Young Sohn; Alexander Becker; Barbara Klein; Irene Schmid; Sabine Greil; Sebastian Lehner; Peter Bartenstein; Thomas Pfluger; Marcus Hacker |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-7-4 |
Journal Detail:
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Title: The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation Volume: - ISSN: 1557-3117 ISO Abbreviation: - Publication Date: 2012 Jul |
Date Detail:
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Created Date: 2012-7-6 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9102703 Medline TA: J Heart Lung Transplant Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Nuclear Medicine, University of Munich, Munich, Germany. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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