The role of 18F-FDG PET/CT in the evaluation of pediatric transplant patients.

OBJECTIVE

Intensive immunosuppressive regimens effectively reduce acute or chronic rejection in transplant patients, while these regimens can result in long term side-effects such as viral infection, fever, secondary tumor(s) etc. Our aim was to evaluate the role of 18-fluoro-2-deoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) in pediatric transplant patients.

SUBJECTS AND METHODS

Forty one (18)F-FDG PET/CT scans in 18 patients before or after transplantation were analyzed retrospectively. One patient had PET/CT scan prior to transplantation. Seventeen patients had PET/CT scan(s) following transplantation. The PET/CT scan was used to evaluate the therapy response of post transplant lymphoproliferative disorder (PTLD) in 11 patients, establish the cause of fever of unknown origin (FUO) in 5 patients, and restage in 2 patients.

RESULTS

PET/CT scan showed development in 3 PTLD patients, improvement in 4 PTLD patients, development and improvement in 1 PTLD patient, new lesions in 1 PTLD patient, and no lesions in 2 PTLD patients. The scan demonstrated the cause of FUO in 2 patients but did not demonstrate the cause of FUO in 2 patients. The PET/CT was false positive in 1 FUO patient and did not show any new lesion(s) in 2 restaging patients.

CONCLUSION

PET/CT may have an important role in follow-up of pediatric transplant patients. Further investigations with more patients are necessary to assess the validity of our findings.