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European Journal of Nuclear Medicine and Molecular Imaging

, Volume 44, Issue 3, pp 421–431

First Online: 12 November 2016Received: 18 July 2016Accepted: 28 October 2016DOI: 10.1007-s00259-016-3564-5

Cite this article as: Wareham, N.E., Lundgren, J.D., Da Cunha-Bang, C. et al. Eur J Nucl Med Mol Imaging 2017 44: 421. doi:10.1007-s00259-016-3564-5


PurposeSolid organ transplant SOT recipients are at high risk of developing infections and malignancies. F-FDG PET-CT may enable timely detection of these diseases and help to ensure early intervention. We aimed to describe the clinical utility of FDG PET-CT in consecutive, diagnostic unresolved SOT recipients transplanted from January 2004 to May 2015.

MethodsRecipients with a post-transplant FDG PET-CT performed as part of diagnostic work-up were included. Detailed chart reviews were done to extract relevant clinical information and determine the final diagnosis related to the FDG PET-CT. Based on á priori defined criteria and the final diagnosis, results from each scan were classified as true or false, and diagnostic values determined.

ResultsAmong the 1,814 recipients in the cohort, 145 had an FDG PET-CT performed; 122 under the indication of diagnostically unresolved symptoms with a suspicion of malignancy or infection. The remaining N = 23 had an FDG PET-CT to follow-up on a known disease or to stage a known malignancy. The 122 recipients underwent a total of 133 FDG PET-CT scans performed for a suspected malignancy 66 % or an infection 34 %. Sensitivity, specificity, and positive and negative predictive values of the FDG PET-CT in diagnosing these conditions were 97, 84, 87, and 96 %, respectively.

ConclusionFDG PET-CT is an accurate diagnostic tool for the work-up of diagnostic unresolved SOT recipients suspected of malignancy or infection. The high sensitivity and NPV underlines the potential usefulness of PET-CT for excluding malignancy or focal infections in this often complex clinical situation.

KeywordsSolid organ transplantation PET-CT Infection Malignancy Diagnostic performance AbbreviationsAMLAcute Myeloid Leukaemia

CHIPCentre of Health and Infectious Disease Research

CIConfidence intervals

CTComputed tomography

EBVEpstein-Barr virus

ESRDEnd-stage renal disease


FUOFever of unknown origin

HIVHuman immunodeficiency virus

IQRInterquartile range


MATCHManagement of Post-Transplant Infections in Collaborating Hospitals


NPVNegative predictive value

PCRPolymerase chain reaction

PETPositron emission tomography

PPVPositive predictive value

PTLDPost-transplant lymphoproliferative disorders

SOTSolid organ transplant

SPSSStatistical Package for the Social Sciences

SUV maxMaximum Standardized Uptake

DTPDual time-point

Electronic supplementary materialThe online version of this article doi:10.1007-s00259-016-3564-5 contains supplementary material, which is available to authorized users.

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Autor: Neval E. Wareham - J. D. Lundgren - C. Da Cunha-Bang - F. Gustafsson - M. Iversen - H. H. Johannesen - A. Kjær - A. R


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