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Graft-versus-host Disease

18F-FDG PET/CT for the assessment of gastrointestinal GVHD: results of a pilot study

Bone Marrow Transplantation volume 49, pages 131–137 (2014)Cite this article

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Abstract

This prospective pilot study aimed to evaluate the predictive value of 18F-FDG PET/CT for early diagnosis of acute gastrointestinal GVHD (GI-GVHD). In all, 42 consecutive patients who received allo-SCT were included. 18F-FDG PET/CT was systematically performed at a median of 28 (range, 24–38) days after allo-SCT. 18F-FDG PET/CT data review was positive in 15 cases (36%) (9 true positive (TP) cases and 6 false positive (FP) cases) and negative in 27 cases (64%; 26 true negative (TN) cases and 1 false negative (FN) case) at visual analysis. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 18F-FDG PET/CT for the diagnosis of acute GI-GVHD were, respectively, 81%, 90%, 60%, 96% and 83%. There were no significant differences of SUVmax values between grade 1–2 GI-GVHD and severe grade 3–4 GI-GVHD. Overall, these preliminary findings suggested that the inflammatory activity of the gastrointestinal tract associated with acute GI-GVHD could be assessed by 18F-FDG PET/CT suggesting that noninvasive 18F-FDG PET/CT could become a valuable examination to be performed shortly before endoscopy to map acute GI-GVHD lesions, guide the biopsy sites and choose the appropriate endoscopic procedure, especially in those asymptomatic patients with a positive 18F-FDG PET/CT.

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Acknowledgements

We acknowledge the technical and logistical support of S Leclercq and V Dehame. We also thank the nursing staff for providing excellent care for our patients, and the following physicians: N Blin, A Clavert, V Dubruille, T Gastinne, S Le Gouill, B Mahe, and F Rialland for their dedicated patient care. EB and FM were supported by educational grants from the ‘Association for Training, Education and Research in Hematology, Immunology and Transplantation’ (ATERHIT). CB-M was supported by a grant from IBA. We also thank the ‘Région Pays de Loire’, the ‘Association pour la Recherche sur le Cancer (ARC; grant no. 3175 to MM)’, the ‘Fondation de France’, the ‘Fondation contre la Leucémie’, the ‘Agence de Biomédecine’, the ‘Association CentpourSang la Vie’, the ‘Association Laurette Fuguain’, the Ligue contre le Cancer and the IRGHET for their generous and continuous support for our clinical and basic research work. Our transplant programs are supported by several grants from the French national cancer institute (PHRC, INCa to MM).

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Authors and Affiliations

  1. Centre Hospitalier et Universitaire (CHU) de Nantes, Service de Médecine Nucléaire Nantes, Nantes, France

    C Bodet-Milin & F Kraeber-Bodere

  2. Université de Nantes, Faculté de Médecine, Nantes, France

    C Bodet-Milin, P Moreau, F Kraeber-Bodere & M Mohty

  3. INSERM CRNCA UMR 892, Nantes, France

    C Bodet-Milin, F Malard, E Brissot, P Moreau, F Kraeber-Bodere & M Mohty

  4. ICO René Gauducheau, Service de Médecine nucléaire, Saint Herblain/Nantes, France

    M Lacombe & F Kraeber-Bodere

  5. Centre Hospitalier et Universitaire (CHU) de Nantes, Service d'Hématologie Clinique, Nantes, France

    F Malard, E Lestang, P Chevallier, T Guillaume, J Delaunay, E Brissot, P Moreau & M Mohty

  6. Centre Hospitalier et Universitaire (CHU) de Rennes, Service d'Hématologie Clinique, Rennes, France

    X Cahu

  7. Centre d'Investigation Clinique en Cancérologie (CI2C), CHU de Nantes, Nantes, France

    P Moreau, F Kraeber-Bodere & M Mohty

  8. Service d’Hématologie Clinique et de Thérapie Cellulaire, Hôpital Saint Antoine, APHP, Paris, France

    M Mohty

  9. Université Pierre et Marie Curie, Paris, France

    M Mohty

  10. INSERM, UMRs 938, Paris, France

    M Mohty

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  1. C Bodet-Milin
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  2. M Lacombe
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  6. P Chevallier
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  8. J Delaunay
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  12. M Mohty
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Correspondence to M Mohty.

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Author contributions

CB-M, ML: collected, assembled and analyzed data and wrote the manuscript; FM, XC: assembled data, performed statistical analysis and helped writing the manuscript; EL, EB: collected data and commented on the manuscript; PC, TG, JD, PM: recruited patients, and commented on the manuscript; MM, FK-B: designed the study, supervised research and helped writing the manuscript. All authors approved submission of the manuscript for publication purposes.

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Bodet-Milin, C., Lacombe, M., Malard, F. et al. 18F-FDG PET/CT for the assessment of gastrointestinal GVHD: results of a pilot study. Bone Marrow Transplant 49, 131–137 (2014). https://doi.org/10.1038/bmt.2013.144

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