Role of 18F-FDG PET/CT in Restrictive Allograft Syndrome after lung transplantation

Background Differential diagnosis of phenotypes of chronic lung allograft dysfunction (CLAD) remains troublesome. We hypothesized that 18F-FDG PET/CT may help in differential diagnosis of CLAD phenotypes, as it showed promising results regarding diagnosis and prognosis in interstitial lung diseases. Methods A monocentric, retrospective study was performed including all lung transplant recipients suffering from bronchiolitis obliterans syndrome (BOS) or restrictive allograft syndrome (RAS) who underwent 18F-FDG PET/CT scan, in comparison with stable lung transplant recipients. Maximum standardized uptake value (SUVmax) was associated with pulmonary function and survival. Proof-of-concept microCT and glucose transporter-1 (GLUT1) staining served as morphologic validation for regions with different SUVmax. Results SUVmax was higher in RAS (median 2.6, n=29) compared to BOS (median 1.0, n=15) and stable patients (median 0.59, n=8) (p

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