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Prognostic value of baseline 18F-FDG PET/CT metabolic parameters in post-transplant lymphoproliferative disorder

Chaoran Wang1,2, Keyu Zhang1, Guanyun Wang1

  • 1Nuclear Medicine Department, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

Quantitative Imaging in Medicine and Surgery
|January 12, 2026
PubMed
Summary
This summary is machine-generated.

Baseline fluorine-18-fluorodeoxyglucose (18F-FDG) PET/CT scans can predict outcomes for pediatric liver transplant patients with post-transplant lymphoproliferative disorder (PTLD). Total lesion glycolysis (tTLG) is a key independent predictor of progression-free survival.

Keywords:
Post-transplant lymphoproliferative disorder (PTLD)fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT)liver transplantpediatricprognosis

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Area of Science:

  • Nuclear Medicine
  • Oncology
  • Transplantation Medicine

Background:

  • Post-transplant lymphoproliferative disorder (PTLD) is a significant complication following pediatric liver transplantation (pLT).
  • Limited studies have assessed the prognostic value of pretreatment fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) in PTLD patients post-pLT.

Purpose of the Study:

  • To evaluate the prognostic significance of baseline 18F-FDG PET/CT imaging in patients diagnosed with PTLD after pLT.
  • To identify metabolic parameters from 18F-FDG PET/CT that predict patient outcomes.

Main Methods:

  • Retrospective analysis of 42 patients with pathologically diagnosed PTLD post-pLT who underwent baseline 18F-FDG PET/CT before treatment.
  • Measurement of metabolic parameters including SUVmax, SUVpeak, SUVavg, MTV, TLG, tMTV, and tTLG.
  • Assessment of prognostic significance using Cox proportional hazards regression and Kaplan-Meier analysis for progression-free survival (PFS).

Main Results:

  • During a median follow-up of 638 days, 61.9% of patients experienced PFS events (recurrence, progression, or mortality).
  • Univariate analysis identified serum tacrolimus level, morphology, SUVmax, TLG, tMTV, and tTLG as significant PFS predictors.
  • Multivariate analysis revealed total TLG (tTLG) as a significant independent predictor of PFS (HR=4.942, P<0.001).

Conclusions:

  • Baseline 18F-FDG PET/CT metabolic parameters are valuable for predicting the prognosis of PTLD patients after pLT.
  • Total lesion glycolysis (tTLG) emerges as a critical independent prognostic factor for progression-free survival in this cohort.