Preliminary application of 18F FDG-PET/CT in post-transplant lymphoproliferative disorders after hematopoietic stem cell transplantation
ZHANG Xiao-chun1, WANG Si-yun1, WANG Shu-xia1, DENG Ning-hong2
1. Department of Nuclear Medicine, Guangdong Provincial People’s Hospital(Guangdong Academy of Medical Sciences), Guangzhou 510080, China; 2. Department of Radiology, Zhuhai Hospital of Guangdong Provincial People’s Hospital, Zhuhai Guangdong 519000, China
Abstract：Objective: To evaluate usefulness of fluorine-18 2-fluoro-2-deoxyglucose PET and computed tomography(18F-FDG PET/CT) in post-transplant lymphoproliferative disorder(PTLD) after hematopoietic stem cell transplantation(HSCT). Methods: From January 2008 to October 2017, the records of all patients that had undergone 18F-FDG PET/CT for evaluation of PTLD after HSCT were analyzed retrospectively. A chart review of clinical information was performed, the imaging features of 18F-FDG PET/CT were reported, and its role in guiding biopsy and evaluating treatment response following therapy was assessed. Results: A total of 9 patients(7 male and 2 female; 18~35 years of age, average: 24 years) were identified. Among them, 6 cases were diagnosed as PTLD based on the pathological result, and another 3 had been treated for PTLD based on clinical findings, elevated EBV, and positive imaging findings. Nine patients had a total of 18 18F-FDG PET/CT scans prior to or following HSCT. Both lymph nodal and extranodal sites of involvement could be detected on 18F-FDG PET/CT images, which showed more lymph node lesions rather than extranodal lesions, and both types of lesions demonstrated increased 18F-FDG uptake. Five patients underwent biopsy guided by 18F-FDG PET/CT images. The biopsy results of 5 cases were positive for PTLD, including polymorphic subtype in 2 cases, polymorphic subtype with local diffuse large B cell lymphoma change in 1 case and diffuse large B-cell lymphoma in 2 cases. One patient underwent biopsy based on palpable cervical lymph nodes and the result was reactive hyperplasia of lymph nodes which was negative for PTLD. There was 1 patient with multiple involvement of the central nervous system which was diffuse large B cell lymphoma on final histology after resection. The corresponding therapeutic protocol was reviewed. Six patients underwent 18F-FDG PET/CT scans to evaluate treatment response following therapy, and all were demonstrated improvement. Conclusion: 18F-FDG PET/CT plays an important role in imaging diagnosis, guided biopsy and therapeutic evaluation of PTLD patients after hematopoietic stem cell transplantation.
张晓春1，王思云1，王淑侠1，邓宁虹2. 18F-FDG PET/CT在造血干细胞移植后淋巴细胞增殖性疾病中的初步应用[J]. 中国临床医学影像杂志, 2019, 30(12): 840-846.
ZHANG Xiao-chun1, WANG Si-yun1, WANG Shu-xia1, DENG Ning-hong2. Preliminary application of 18F FDG-PET/CT in post-transplant lymphoproliferative disorders after hematopoietic stem cell transplantation. JOURNAL OF CHINA MEDICAL IMAGING, 2019, 30(12): 840-846.
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