Diagnostic Performance of 18F-FDG PET or PET/CT for Detection of Post-Transplant Lymphoproliferative Disorder: A Systematic Review and a Bivariate Meta-Analysis

Veronika Ballova; Barbara Muoio; Domenico Albano; Francesco Bertagna; Luca Canziani; Michele Ghielmini; Luca Ceriani; Giorgio Treglia

doi:10.3390/diagnostics10020101

Diagnostic Performance of ¹⁸F-FDG PET or PET/CT for Detection of Post-Transplant Lymphoproliferative Disorder: A Systematic Review and a Bivariate Meta-Analysis

Diagnostics (Basel). 2020 Feb 12;10(2):101. doi: 10.3390/diagnostics10020101.

Authors

Veronika Ballova¹, Barbara Muoio², Domenico Albano³, Francesco Bertagna³, Luca Canziani⁴, Michele Ghielmini^{5

6}, Luca Ceriani^{7

8}, Giorgio Treglia^{5

7

9}

Affiliations

¹ Department of Oncology and Hematology, Cantonal Hospital Baden, CH-5404 Baden, Switzerland.
² Clinic of Medical Oncology, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, CH-6500 Bellinzona, Switzerland.
³ Nuclear Medicine, University of Brescia and Spedali Civili Brescia, IT-25123 Brescia, Italy.
⁴ Department of Haematology and Oncology, Niguarda Hospital, IT-20162 Milan, Italy.
⁵ Academic Education Research and Innovation Area, General Directorate, Ente Ospedaliero Cantonale, CH-6500 Bellinzona, Switzerland.
⁶ Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), CH-6900 Lugano, Switzerland.
⁷ Clinic of Nuclear Medicine and Molecular Imaging, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, CH-6900 Lugano, Switzerland.
⁸ Institute of Oncology Research, CH-6500 Bellinzona, Switzerland.
⁹ Department of Nuclear Medicine and Molecular Imaging, University of Lausanne and Lausanne University Hospital, CH-1011 Lausanne, Switzerland.

Abstract

Background: Some studies evaluated the diagnostic performance of fluorine-18-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography or positron emission tomography/computed tomography (PET or PET/CT) for the detection of post-transplant lymphoproliferative disorder (PTLD). As there is no clear consensus about the diagnostic accuracy of these imaging methods, we performed a meta-analysis on this topic.

Methods: A comprehensive computer literature search of PubMed, Embase, and Cochrane library databases through December 2019 was performed. Pooled sensitivity, specificity, positive and negative likelihood ratios (LR+ and LR-), and diagnostic odds ratio (DOR) of ¹⁸F-FDG PET or PET/CT for detection of PTLD were calculated.

Results: Five studies reporting data on the diagnostic performance of ¹⁸F-FDG PET or PET/CT in 336 transplant recipients were included in the systematic review and bivariate meta-analysis. Pooled sensitivity and specificity for detection of PTLD were 89.7% (95% confidence interval (95%CI): 84.6-93.2%) and 90.9% (95%CI: 85.9-94.3%), respectively. Pooled LR+, LR-, and DOR were 8.9 (95%CI: 5.7-14), 0.13 (95%CI: 0.08-0.2), and 70.4 (95%CI: 35.4-140), respectively. A significant heterogeneity among studies was not detected.

Conclusions: Despite limited literature data, ¹⁸F-FDG PET or PET/CT demonstrated good diagnostic performance for the detection of PTLD, but large prospective studies are needed to strengthen these findings.

Keywords: 18F-FDG; PET; PTLD; lymphoma; meta-analysis; post-transplant lymphoproliferative disorder.

Publication types

Review