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FDG-PET/CT in Heart Transplant

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FDG-PET/CT and PET/MR in Cardiovascular Diseases

Abstract

Heart transplantation remains the best treatment option for patients with end-stage heart failure to improve quality of life and survival despite significant improvements in both medical therapies and mechanical circulatory support devices. Nevertheless, given the shortage of donor hearts and increased waiting time, more patients need mechanical circulatory support as a bridge to transplant or even as destination therapy with an inherent risk of infectious complications. Furthermore, heart transplant recipients are at risk for developing several mild to potentially life-threatening complications, thereby impairing their outcome. These complications vary according to the time after transplant surgery and can be divided into graft-related (early graft failure, allograft rejection, and cardiac allograft vasculopathy) and non–graft-related disorders such as infections and malignancies. Positron emission tomography combined with computed tomography using 2-deoxy-2-[18F]fluoro-d-glucose (FDG-PET/CT) is an established tool in oncology and has become the reference standard to noninvasively assess infectious and inflammatory processes with high accuracy. This chapter provides a brief overview on the current state of heart transplantation and complications during the posttransplant period. Secondly, a concise update is given on the diagnostic value of FDG-PET/CT in ventricular assist device infections in the pretransplant setting. Then, graft-related complications are discussed focusing on the potential role of FDG-PET/CT to detect allograft rejection. The last part summarizes the current evidence on the use of FDG-PET/CT in the workup of infectious complications and lymphoproliferative disorders after heart transplantation.

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Author information

Authors and Affiliations

  1. Department of Cardiology, University Hospitals Leuven, Leuven, Belgium

    Johan Van Cleemput

  2. Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium

    Johan Van Cleemput

  3. Laboratory for Experimental Hematology, Department of Hematology, KU Leuven, University Hospitals Leuven, Leuven, Belgium

    Daan Dierickx

  4. Department of Nuclear Medicine, Cliniques Universitaires Saint-Luc and Institute of Clinical and Experimental Research (IREC), Université Catholique de Louvain (UC Louvain), Brussels, Belgium

    Olivier Gheysens

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  1. Johan Van Cleemput
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  2. Daan Dierickx
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  3. Olivier Gheysens
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Correspondence to Olivier Gheysens .

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Editors and Affiliations

  1. Montreal Heart Institute, Montréal, QC, Canada

    Matthieu Pelletier-Galarneau

  2. BC Cancer Agency, Vancouver, BC, Canada

    Patrick Martineau

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Van Cleemput, J., Dierickx, D., Gheysens, O. (2022). FDG-PET/CT in Heart Transplant. In: Pelletier-Galarneau, M., Martineau, P. (eds) FDG-PET/CT and PET/MR in Cardiovascular Diseases. Springer, Cham. https://doi.org/10.1007/978-3-031-09807-9_22

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