Nuclear Medicine Department, Lapeyronie Hospital, Montpellier University Hospitals, Montpellier, France.
Cardiology Department, Arnaud-de-Villeneuve Hospital, Montpellier University Hospitals, PhyMedExp, INSERM, CNRS, Montpellier University, Montpellier, France.
Medicine (Baltimore). 2023 Sep 29;102(39):e35296. doi: 10.1097/MD.0000000000035296.
Evaluate 18-FDG positron emission tomography (PET) diagnostic capabilities for cancer screening in heart transplant patients. We conducted an anonymized retrospective observational study of heart transplant patients followed in the University Hospital of Montpellier, France. We analyzed 303 18-FDG PET from 158 patients. We compared demographic and clinical characteristics through uni- and multivariate analysis: in the cancer-free group, comparisons were made between the PET false positive (FP) group versus true negative (TN), and in the cancer group, comparisons were made between the PET false negative (FN) group versus true positive (TP). Out of the 303 exams, we found 245 TN, 26 TP, 26 FP and 6 FN. The sensitivity rate was calculated at 81%, the specificity rate at 90%, the positive predictive value at 50%, and the negative predictive value at 97%. The multivariate analysis showed an association between FP diagnosis and graft-PET delay (P value = .046, OR = 5.14, 95% CI [1.18-32.4]) and creatine reactive protein (CRP) ≥ 10 mg/L (P value = .042, OR = 4.21, 95% CI [1.02-17.2]). The estimated probability of FP by logit regression was 0.48 with 95% CI [0.21-0.77] when graft-PET delay ≥ 6 years and CRP ≥ 10 mg/L. No significative statistical link was found for the demographic or clinical characteristics in the FN group of patients with cancer, except for sex (all FN were men). 18-FDG PET performed very well in the follow-up of heart transplant patients for neoplasia screening, with better specificity than sensitivity. However, the study showed that almost 50% of FP can be predicted by considering only the graft-PET delay and CRP.
评估 18-FDG 正电子发射断层扫描（PET）在心脏移植患者癌症筛查中的诊断能力。我们对法国蒙彼利埃大学医院的心脏移植患者进行了一项匿名回顾性观察研究。我们分析了 158 名患者的 303 例 18-FDG PET。我们通过单变量和多变量分析比较了人口统计学和临床特征：在无癌症组中，将 PET 假阳性（FP）组与真阴性（TN）组进行比较，在癌症组中，将 PET 假阴性（FN）组与真阳性（TP）组进行比较。在 303 次检查中，我们发现 245 次 TN、26 次 TP、26 次 FP 和 6 次 FN。敏感性率为 81%，特异性率为 90%，阳性预测值为 50%，阴性预测值为 97%。多变量分析显示 FP 诊断与移植物-PET 延迟（P 值=0.046，OR=5.14，95%CI[1.18-32.4]）和肌酸反应蛋白（CRP）≥10mg/L（P 值=0.042，OR=4.21，95%CI[1.02-17.2]）之间存在关联。通过对数回归估计的 FP 概率为 0.48，95%CI[0.21-0.77]，当移植物-PET 延迟≥6 年且 CRP≥10mg/L 时。在患有癌症的 FN 组患者中，除性别（所有 FN 均为男性）外，人口统计学或临床特征均未显示出统计学意义。18-FDG PET 在心脏移植患者肿瘤筛查的随访中表现非常出色，特异性优于敏感性。然而，该研究表明，仅考虑移植物-PET 延迟和 CRP，近 50%的 FP 是可以预测的。
