Montes de Jesus Felipe, Vergote V, Noordzij W, Dierickx D, Dierckx R A J O, Diepstra A, Tousseyn T, Gheysens O, Kwee T C, Deroose C M, Glaudemans A W J M
Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands.
Department of Hematology, University Hospitals Leuven, 3000 Leuven, Belgium.
J Clin Med. 2021 Jan 19;10(2):361. doi: 10.3390/jcm10020361.
Post-transplant lymphoproliferative disorder (PTLD) is a complication of organ transplantation classified according to the WHO as nondestructive, polymorphic, monomorphic, and classic Hodgkin Lymphoma subtypes. In this retrospective study, we investigated the potential of semi-quantitative 2-[F]fluoro-2-deoxy-D-glucose ([F]FDG) PET/computed tomography (CT)-based parameters to differentiate between the PTLD morphological subtypes. 96 patients with histopathologically confirmed PTLD and baseline [F]FDG PET/CT between 2009 and 2019 were included. Extracted semi-quantitative measurements included: Maximum, peak, and mean standardized uptake value (SUV, SUV, and SUV). Median SUVs were highest for monomorphic PTLD followed by polymorphic and nondestructive subtypes. The median SUV at the biopsy site was significantly higher in monomorphic PTLD (17.8, interquartile range (IQR):16) than in polymorphic subtypes (9.8, IQR:13.4) and nondestructive (4.1, IQR:6.1) ( = 0.04 and ≤ 0.01, respectively). An SUV ≥ 24.8 was always indicative of a monomorphic PTLD in our dataset. Nevertheless, there was a considerable overlap in SUV across the different morphologies. The median SUV at the biopsy site was significantly higher in monomorphic PTLD than polymorphic and nondestructive subtypes. However, due to significant SUV overlap across the different subtypes, these values may only serve as an indication of PTLD morphology, and SUV-based parameters cannot replace histopathological classification.
移植后淋巴细胞增生性疾病（PTLD）是器官移植的一种并发症，根据世界卫生组织的分类，可分为非破坏性、多形性、单形性和经典霍奇金淋巴瘤亚型。在这项回顾性研究中，我们调查了基于半定量2-[F]氟-2-脱氧-D-葡萄糖（[F]FDG）PET/计算机断层扫描（CT）的参数区分PTLD形态学亚型的潜力。纳入了96例在2009年至2019年间经组织病理学确诊为PTLD且有基线[F]FDG PET/CT的患者。提取的半定量测量值包括：最大、峰值和平均标准化摄取值（SUVmax、SUVpeak和SUVmean）。单形性PTLD的SUV中位数最高，其次是多形性和非破坏性亚型。单形性PTLD活检部位的SUV中位数（17.8，四分位间距（IQR）：16）显著高于多形性亚型（9.8，IQR：13.4）和非破坏性亚型（4.1，IQR：6.1）（分别为P = 0.04和P≤0.01）。在我们的数据集中，SUV≥24.8总是提示单形性PTLD。然而，不同形态的SUV存在相当大的重叠。单形性PTLD活检部位的SUV中位数显著高于多形性和非破坏性亚型。然而，由于不同亚型之间SUV存在显著重叠，这些值可能仅作为PTLD形态的一个指标，基于SUV的参数不能替代组织病理学分类。
