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Title
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Role of F-18-FDG PET/CT in Restrictive Allograft Syndrome After Lung Transplantation
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Author
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Abstract
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| Background. Differential diagnosis of phenotypes of chronic lung allograft dysfunction (CLAD) remains troublesome. We hypothesized that F-18-fluorodeoxyglucose positron emission tomography with computed tomography (F-18-FDG PET/CT) may help in differential diagnosis of CLAD phenotypes, as it showed promising results regarding diagnosis and prognosis in interstitial lung diseases. Methods. A monocentric, retrospective study was performed including all lung transplant recipients suffering from bronchiolitis obliterans syndrome (BOS) or restrictive allograft syndrome (RAS) who underwent F-18-FDG PET/CT scan, in comparison with stable lung transplant recipients. Maximum standardized uptake value (SUVmax) was associated with pulmonary function and survival. Proof-of-concept microCT and glucose transporter-1 staining served as morphologic validation for regions with different SUVmax. Results. Maximum standardized uptake value was higher in RAS (median, 2.6; n = 29) compared with BOS (median, 1.0; n = 15) and stable patients (median, 0.59; n = 8) (P < 0.0001). In RAS, high SUVmax was associated with worse survival after F-18-FDG PET/CT (P = 0.0004; hazard ratio, 1.82). Forced vital capacity at F-18-FDG PET/CT inversely correlated with SUVmax (R = -0.40, P = 0.03). MicroCT analysis revealed extensive fibrosis in regions of high SUVmax, with an increased number of glucose transporter-1-positive cells. Conclusions. F-18-fluorodeoxyglucose positron emission tomography with CT may noninvasively differentiate RAS from BOS. RAS patients with areas of increased lung metabolism have worse outcome, demonstrating the potential use of F-18-FDG PET/CT during follow-up after lung transplantation. |
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Language
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English
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Source (journal)
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Transplantation. - Baltimore, Md, 1963, currens
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Publication
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Baltimore, Md
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2019
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ISSN
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0041-1337
1534-6080
[online]
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DOI
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10.1097/TP.0000000000002393
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Volume/pages
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103
:4
(2019)
, p. 823-831
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ISI
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000480679400036
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Pubmed ID
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30086092
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Full text (Publisher's DOI)
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