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Preliminary experience on the use of PET/CT in the management of pediatric post‐transplant lymphoproliferative disorder
Author(s) -
GuerraGarcía Pilar,
Hirsch Steffen,
Levine Daniel S,
Taj Mary M.
Publication year - 2017
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.26685
Subject(s) - medicine , post transplant lymphoproliferative disorder , positron emission tomography , radiology , magnetic resonance imaging , lymphoma , immunosuppression , pet ct , lymphoproliferative disorders , nuclear medicine , rituximab
Post‐transplant lymphoproliferative disorder (PTLD) is a well‐known complication following prolonged immunosuppression. Contrary to other lymphomas, there is no standardized imaging approach to assess PTLD either at staging or for response to therapy. Positron emission tomography/computed tomography (PET/CT) is an imaging modality that has proven to be useful in lymphoma. However, there is still limited data concerning its use in pediatric PTLD. Our study evaluates the use of PET/CT in pediatric PTLD at our institution. Methods To assess the role of PET/CT in pediatric PTLD, we reviewed the pediatric patients with PTLD who had undergone PET/CT at our institution between 2000 and 2016. Results Nine patients were identified. Six had PET/CT at diagnosis. All lesions seen on CT were identified with PET/CT. Fourteen PET/CTs were done during treatment. Eight PET/CTs were negative, including three where CT showed areas of uncertain significance. In these cases, PET/CT helped us to stop treatment and the patients remain in remission after a long follow‐up (mean 74.3 months; range 12.4–180.9 months). PET/CT revealed additional disease in two cases, therefore treatment was intensified. Six biopsies and close follow‐up was done to confirm PET/CT results. In one case, PET/CT did not identify central nervous system involvement demonstrated on magnetic resonance imaging. Conclusion PET/CT may have an important role in the staging and follow‐up of pediatric PTLD. In our cohort, PET/CT was helpful in staging and assessing treatment response and in clarifying equivocal findings on other imaging modalities.