Current Studies in Diagnostic Imaging
FDG-PET/CT in the Evaluation of Post-Transplant Lymphoproliferative Disorder in Children Following Solid Organ Transplantation
Dr. Amer Shammas, The Hospital for Sick Children
Dr. Angela Punnett, The Hospital for Sick Children
Dr. Paul Babyn, Saskatoon
Post-transplant lymphoproliferative disorder (PTLD) is a complication of solid organ or bone marrow transplants and is the most common disorder to affect children post-transplant.
PTLD may occur at any time after transplantation but the risk of developing PTLD is greatest within the first year and declines over time. Currently, diagnostic imaging for patients with suspected or confirmed PTLD consists of scans such as computed tomography (CT) and magnetic resonance imaging (MRI) which show organ structure, and positron emission tomography (PET) which shows organ function. A PET scan can detect small amounts of tumour that might be missed by other types of radiology exams.
During a PET scan, a patient receives an injection of a small amount of radioactive glucose (sugar) into their bloodstream; in this study FDG is used. In recent years, PET/CT scans (a fusion of structure and function information from CT and PET respectively) have been used for staging of many malignancies. PET/CT is useful because it permits whole-body coverage, making it useful for imaging widespread diseases.
This study will evaluate whether FDG-PET/CT can detect additional lesions in children with PTLD after solid organ transplantations compared with standard anatomic imaging (such as CT and MRI). Additionally, this study will determine whether FDG-PET/CT can predict early response during the course of treatment therapy and whether baseline FDG-PET/CT can be used to guide biopsy.
This study will compare findings of FDG-PET/CT imaging to anatomic imaging such as CT and MRI which are the current standard of care for PTLD. This comparison will be conducted at four time points: during the initial assessment of PTLD (baseline), during therapy, at the end of therapy (six weeks after completion of therapy) and during post-therapy follow-up (six months later).
Clinical follow-up, including results from histopathologic tests and biopsies will be used to compare diagnostic accuracy of PET/CT and anatomic imaging. Through this, it will be determined whether FDG-PET/CT can detect additional lesions in children with PTLD after solid organ transplant when compared to anatomic imaging modalities such as CT and MRI.
SickKids patients with a known or suspected diagnosis of PTLD following solid organ transplantation, who are referred for PET/CT imaging by their physician for disease evaluation.
There will be 20 participants enrolled on this study.
March 2011 - December 2012
Dr. Amer Shammas
Comprehensive Cancer Centre