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Non-invasive Imaging of Acute Allograft Rejection after Rat Renal Transplantation Using 18F-FDG PET
Published on: April 28, 2013
18F-FLT PET and Blood-based Biomarkers for Identifying Gastrointestinal Graft versus Host Disease after Allogeneic
Jennifer Holter-Chakrabarty1, Lacey McNally1, John Levine1
1From the Stephenson Cancer Center, University of Oklahoma Health Sciences Center, 800 NE 10th St, Oklahoma City, OK 73104 (J.H.C., L.M., S.K.V., Z.H., M.P., J.G., Y.W.); Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY (J.L., J.F.); Department of Biostatistics and Epidemiology, Hudson College of Public Health, The University of Oklahoma, Oklahoma City, Okla (S.K.V., T.G.); Experimental Transplantation and Immunotherapy Branch, National Cancer Institute, National Institutes of Health, Bethesda, Md (C.G.K., R.G.); Department of Biomedical Engineering, University of Central Oklahoma, Edmond, Okla (Z.H.); and Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Emory University, Atlanta, GA (K.M.W.).
Purpose To determine whether fluorine 18 (18F) fluorothymidine (FLT) PET imaging alone or combined with Mount Sinai Acute GVHD International Consortium (MAGIC) biomarkers could help identify subclinical gastrointestinal graft versus host disease (GI-GVHD) by day 100 following hematopoietic stem cell transplantation (HSCT). Materials and Methods 18F-FLT PET imaging was analyzed in a prospective pilot study (ClinicalTrials.gov identifier no. NCT01338987) with a primary end point of engraftment for a planned secondary end point identifying GI-GVHD. Regions of interest (ROIs) in the colon (1 cm3), jejunum (1 cm3), and ileum (1 cm3) were drawn in the area of greatest signal intensity within each segment of the GI tract by using software. Standardized uptake values (SUVs) were captured on day 28 following transplantation, along with MAGIC serum biomarkers and MAGIC algorithm probability (MAP) scores using MAGIC serum biomarkers collected at days 28-35. Results Among 20 participants (median age, 33.85 years [IQR: 28.65-39.25 years]; 11 female, nine male), seven presented with clinically diagnosed GI-GVHD by 100 days. Increased SUV was observed throughout the GI tract, most predominantly in the jejunum. Maximum and mean SUV by day 100 were significantly elevated in those with GI-GVHD (maximum SUV, 4.81; mean SUV, 3.73; n = 7) compared with those without (maximum SUV, 3.99; mean SUV, 2.56). MAP score (P = .02) was associated with acute GVHD on day 28 but not on day 100. Spearman correlation between maximum SUV in the jejunum and MAP score was r = 0.65 (P = .002). Conclusion These data suggest that 18F-FLT PET may help identify acute GI-GVHD after HSCT and could inform location in areas difficult to biopsy. Keywords: Transplantation, PET/CT, Bone Marrow, Abdomen/GI ClinicalTrials.gov identifier: NCT01338987 © RSNA, 2024.
Purpose To determine whether fluorine 18 (18F) fluorothymidine (FLT) PET imaging alone or combined with Mount Sinai Acute GVHD International Consortium (MAGIC) biomarkers could help identify subclinical gastrointestinal graft versus host disease (GI-GVHD) by day 100 following hematopoietic stem cell transplantation (HSCT). Materials and Methods 18F-FLT PET imaging was analyzed in a prospective pilot study (ClinicalTrials.gov identifier no. NCT01338987) with a primary end point of engraftment for a planned secondary end point identifying GI-GVHD. Regions of interest (ROIs) in the colon (1 cm3), jejunum (1 cm3), and ileum (1 cm3) were drawn in the area of greatest signal intensity within each segment of the GI tract by using software. Standardized uptake values (SUVs) were captured on day 28 following transplantation, along with MAGIC serum biomarkers and MAGIC algorithm probability (MAP) scores using MAGIC serum biomarkers collected at days 28-35. Results Among 20 participants (median age, 33.85 years [IQR: 28.65-39.25 years]; 11 female, nine male), seven presented with clinically diagnosed GI-GVHD by 100 days. Increased SUV was observed throughout the GI tract, most predominantly in the jejunum. Maximum and mean SUV by day 100 were significantly elevated in those with GI-GVHD (maximum SUV, 4.81; mean SUV, 3.73; n = 7) compared with those without (maximum SUV, 3.99; mean SUV, 2.56). MAP score (P = .02) was associated with acute GVHD on day 28 but not on day 100. Spearman correlation between maximum SUV in the jejunum and MAP score was r = 0.65 (P = .002). Conclusion These data suggest that 18F-FLT PET may help identify acute GI-GVHD after HSCT and could inform location in areas difficult to biopsy. Keywords: Transplantation, PET/CT, Bone Marrow, Abdomen/GI ClinicalTrials.gov identifier: NCT01338987 © RSNA, 2024.
