Unpublished conference/Abstract (Scientific congresses and symposiums)
18FDG-PET/CT IMAGING IN SUSPECTED ACUTE RENAL ALLOGRAFT REJECTION
LOVINFOSSE, Pierre; WEEKERS, Laurent; BOVY, Christophe et al.
201517th Congress of the European Society for Organ Transplantation
 

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Keywords :
Rejection; Techniques; Recipient management; Kidney clinical
Abstract :
[en] The diagnosis procedure for kidney transplant recipients (KTR) with suspected acute rejection (AR) relies on needle biopsy. Noninvasive tests to predict nonrejection would be preferable. AR is associated with a recruitment of activated leukocytes into the transplant, which are characterized by a high metabolic activity and an increased uptake of glucose analog, Fluoro-deoxyglucose ( FDG). Thus, FDG-Positron emission tomography coupled with computed tomography (PET/CT) may help noninvasively distinguish nonrejection from AR. From January 2013 to February 2015, we prospectively performed 32 FDGPET/ CT in 31 adult KTR with suspected renal AR who underwent a biopsy. Biopsies were categorized as “normal”, “borderline”, “AR” or “others” according to Banff classification. PET/CT imaging was performed within 201 ± 18 minutes after i.v. administration of 3.2 ± 0.2 MBq/kg of FDG, before any modification of immunosuppression. The mean standard uptake values (SUV) of both upper and lower renal poles were measured, with no threshold activity. Biopsies were diagnosed as “normal”, “borderline”, “AR” or “others” in 8, 10, 8 and 6 (including 3 polyoma-BK nephropathies) cases. Mean SUV respectively reached 1.5 ± 0.2, 1.6 ± 0.3, 2.9 ± 0.8, 2.2 ± 1.2 in each category. Mean SUV of biopsy-proven AR was significantly higher than “normal” cases (p<0.01). No difference was found between “normal” vs. “borderline”, or between “AR” vs. “others” histopathology. Still, a positive correlation between mean SUV and acute composite (g+i+t+v+ptc) Banff score was found, with a coefficient of 0.70 (p<0.001). Sensitivity and specificity of FDG-PET/CT in detecting pathological biospies were respectively 92.3% and 36.8%, with a mean SUV threshold at 1.4. FDG-PET/CT imaging may help discriminate nonrejection, thereby avoiding unnecessary transplant biopsy in KTR with suspected AR.
Disciplines :
Urology & nephrology
Radiology, nuclear medicine & imaging
Author, co-author :
LOVINFOSSE, Pierre ;  Centre Hospitalier Universitaire de Liège - CHU > Service médical de médecine nucléaire et imagerie onco
WEEKERS, Laurent  ;  Centre Hospitalier Universitaire de Liège - CHU > Néphrologie
BOVY, Christophe ;  Centre Hospitalier Universitaire de Liège - CHU > Néphrologie
BONVOISIN, Catherine ;  Centre Hospitalier Universitaire de Liège - CHU > Néphrologie
GROSCH, Stéphanie ;  Centre Hospitalier Universitaire de Liège - CHU > Néphrologie
KRZESINSKI, Jean-Marie ;  Centre Hospitalier Universitaire de Liège - CHU > Néphrologie
Hustinx, Roland  ;  Université de Liège > Département des sciences cliniques > Médecine nucléaire
Jouret, François  ;  Université de Liège > Département des sciences cliniques > Néphrologie
Language :
English
Title :
18FDG-PET/CT IMAGING IN SUSPECTED ACUTE RENAL ALLOGRAFT REJECTION
Publication date :
13 September 2015
Event name :
17th Congress of the European Society for Organ Transplantation
Event organizer :
European Society for Organ Transplantation
Event place :
Brussels, Belgium
Event date :
du 13 au 16 septembre 2015
By request :
Yes
Audience :
International
Available on ORBi :
since 23 September 2015

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