• Christopher S Takehana, Clare J Twist, Camila Mosci, Andrew Quon, Erik Mittra, and Andrei Iagaru.
• aDivision of Nuclear Medicine and Molecular Imaging, Stanford University Medical Center bLucile Packard Children's Hospital, Stanford, California, USA.
• Nucl Med Commun. 2014 Mar 1; 35 (3): 276-81.

ObjectivesPost-transplant lymphoproliferative disorder (PTLD) is a rare but serious complication in transplant patients. Although fluorine-18 2-fluoro-2-deoxyglucose PET and computed tomography ((18)F-FDG PET/CT) has been used for the evaluation and management of patients with PTLD, its utility has yet to be documented. We were therefore prompted to review our experience with (18)F-FDG PET/CT in PTLD.Materials And MethodsWe retrospectively reviewed the records of consecutive patients who had undergone (18)F-FDG PET/CT for evaluation of PTLD from January 2004 to June 2012 at our institution. (18)F-FDG PET/CT scans were compared with other imaging modalities performed concurrently. A chart review of pertinent clinical information was also conducted.ResultsA total of 30 patients were identified (14 female and 16 male; 1.7-76.7 years of age, average: 23.8 years). Twenty-seven participants had biopsy-proven PTLD and another three had been treated for PTLD because of high clinical suspicion of disease and positive (18)F-FDG PET/CT findings in the absence of histological diagnosis. Eighty-three percent of these PTLD patients had extranodal involvement. In 57% of the cases, (18)F-FDG PET/CT detected occult lesions not identified on other imaging modalities or suggested PTLD in equivocal lesions. The more aggressive PTLD histological subtypes demonstrated higher SUVmax compared with the less aggressive subtypes.Conclusion(18)F-FDG PET/CT is beneficial in the diagnostic evaluation of patients with PTLD. (18)F-FDG PET/CT has the ability to detect occult lesions not identified on other imaging modalities, particularly extranodal lesions. In addition, (18)F-FDG PET/CT may predict the PTLD subtype, as the lesions with higher pathologic grade presented with significantly higher SUVmax compared with the less aggressive forms.

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