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Diagnostic role of whole-body [(18)F]-FDG positron emission tomography in patients with symptoms suspicious for malignancy after heart transplantation.
MedLine Citation:
PMID:  22766023     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  JOURNAL ARTICLE     Date:  2012-7-4
Journal Detail:
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:
Created Date:  2012-7-6     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9102703     Medline TA:  J Heart Lung Transplant     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Nuclear Medicine, University of Munich, Munich, Germany.
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