PURPOSE Post-transplant lymphoproliferative disorder (PTLD) is a serious complication after solid organ and hematopoietic stem cell transplantation, requiring a timely and accurate diagnosis. In this study, we evaluated the diagnostic performance of FDG-PET/CT in patients with suspected PTLD and examined if lactate dehydrogenase (LDH) levels, Epstein-Barr virus (EBV) load, or timing of FDG-PET/CT relate to detection performance of FDG-PET/CT. METHODS This retrospective study included 91 consecutive patients with clinical suspicion of PTLD and a total of 97 FDG-PET/CT scans within an 8-year period. Pathology reports and a 2-year follow-up were used as the reference standard. Diagnostic performance of FDG-PET/CT for detection of PTLD as well as logistic regression analysis for factors expected to affect diagnostic yield were assessed. RESULTS The diagnosis of PTLD was established in 34 patients (35%). Fifty-seven FDG-PET/CT scans (59%) were true negative, 29 (30%) were true positive, 6 (6%) false positive, and 5 (5%) false negative. Sensitivity of FDG-PET/CT for the detection of PTLD was 85%, specificity 90%, positive predictive value 83%, and negative predictive value 92%, with good inter-observer variability (k = 0.78). Of the parameters hypothesized to be associated with a true positive FDG-PET/CT result for the diagnosis of PTLD, only LDH was statistically significant (OR 1.03, p = 0.04). CONCLUSION FDG-PET/CT has a good diagnostic performance in patients suspected of PTLD, with a good inter-observer agreement. Only LDH levels seemed to influence the detection performance of FDG-PET/CT. EBV-DNA load and timing of FDG-PET/CT after transplantation did not affect FDG-PET/CT diagnostic yield.

中文翻译：

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FDG-PET / CT对移植后淋巴组织增生性疾病的诊断性能以及影响诊断率的因素。

目的移植后淋巴组织增生性疾病（PTLD）是实体器官和造血干细胞移植后的严重并发症，需要及时准确的诊断。在这项研究中，我们评估了FDG-PET / CT在可疑PTLD患者中的诊断性能，并检查了乳酸脱氢酶（LDH）水平，爱泼斯坦-巴尔病毒（EBV）负荷或FDG-PET / CT的时机是否与检测有关FDG-PET / CT的性能。方法这项回顾性研究纳入了91名连续8年内临床怀疑为PTLD的患者，并进行了97次FDG-PET / CT扫描。病理报告和两年随访作为参考标准。评估了FDG-PET / CT对PTLD检测的诊断性能以及对预期影响诊断率的因素的逻辑回归分析。结果PTLD的诊断在34例患者中占35％。FDG-PET / CT扫描共进行了57例（59％）为真阴性，29例（30％）为真阳性，6例（6％）假阳性，5例（5％）假阴性。FDG-PET / CT对PTLD检测的敏感性为85％，特异性90％，阳性预测值83％和阴性预测值92％，观察者间的差异性良好（k = 0.78）。假设与真正的FDG-PET / CT阳性结果相关的参数可诊断PTLD，只有LDH具有统计学意义（OR 1.03，p = 0.04）。结论FDG-PET / CT对疑似PTLD的患者具有良好的诊断性能，并具有良好的观察者间共识。只有LDH水平似乎会影响FDG-PET / CT的检测性能。