Diagnostic performance of FDG-PET/CT of post-transplant lymphoproliferative disorder and factors affecting diagnostic yield

de Jesus, F. M. M., Kwee, T. C., Kahle, X. U., Nijland, M., van Meerten, T., Huls, G., Dierckx, R. A. J. O., Rosati, S., Diepstra, A., van der Bij, W., Verschuuren, E. A. M., Glaudemans, A. W. J. M. & Noordzij, W., Mar-2020, In : European Journal of Nuclear Medicine and Molecular Imaging. 47, 3, p. 529-536 8 p.

Research output: Contribution to journalArticleAcademicpeer-review

PURPOSE: Post-transplant lymphoproliferative disorder (PTLD) is a serious complication after solid organ and hematopoietic stem cell transplantation, requiring a timely and accurate diagnosis. In this study, we evaluated the diagnostic performance of FDG-PET/CT in patients with suspected PTLD and examined if lactate dehydrogenase (LDH) levels, Epstein-Barr virus (EBV) load, or timing of FDG-PET/CT relate to detection performance of FDG-PET/CT.

METHODS: This retrospective study included 91 consecutive patients with clinical suspicion of PTLD and a total of 97 FDG-PET/CT scans within an 8-year period. Pathology reports and a 2-year follow-up were used as the reference standard. Diagnostic performance of FDG-PET/CT for detection of PTLD as well as logistic regression analysis for factors expected to affect diagnostic yield were assessed.

RESULTS: The diagnosis of PTLD was established in 34 patients (35%). Fifty-seven FDG-PET/CT scans (59%) were true negative, 29 (30%) were true positive, 6 (6%) false positive, and 5 (5%) false negative. Sensitivity of FDG-PET/CT for the detection of PTLD was 85%, specificity 90%, positive predictive value 83%, and negative predictive value 92%, with good inter-observer variability (k = 0.78). Of the parameters hypothesized to be associated with a true positive FDG-PET/CT result for the diagnosis of PTLD, only LDH was statistically significant (OR 1.03, p = 0.04).

CONCLUSION: FDG-PET/CT has a good diagnostic performance in patients suspected of PTLD, with a good inter-observer agreement. Only LDH levels seemed to influence the detection performance of FDG-PET/CT. EBV-DNA load and timing of FDG-PET/CT after transplantation did not affect FDG-PET/CT diagnostic yield.

Original languageEnglish
Pages (from-to)529-536
Number of pages8
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Issue number3
Early online date24-Aug-2019
Publication statusPublished - Mar-2020


  • Post-transplant lymphoproliferative disorder, F-18-Fluoro-D-deoxyglucose positron emission tomography, FDG-PET, CT, Diagnosis, POSITRON-EMISSION-TOMOGRAPHY, B-CELL LYMPHOMA, BARR VIRAL LOAD, RISK, RECIPIENTS, SURVIVAL

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