Figure Legends
FIGURE 1 A 6-month-old boy received pLT for biliary atresia.18F-FDG PET/CT was performed 2 years and 6 months after the operation due to long-term fever and lymphadenopathy. Key findings of the 18F-FDG PET/CT scan report include the following. First, there were multiple enlarged lymph nodes in the cervical, bilateral parapharyngeal space and right supraclavicular fossa, with abnormally high metabolism, and PTLD was considered. Second, the wall of the nasopharynx was diffusely thickened and the metabolism was abnormally increased; additionally, the morphology of the bilateral tonsils is plump, and the metabolism is diffusely and abnormally high; so, inflammation was considered in our conclusion. (A and B) Maximum-intensity projection and fusion of 18F-FDG PET/CT at the lymph node biopsy site. (C) Axial fusion18F-FDG PET/CT imaging revealed high uptake in the right cervical lymph node. (D) During diagnostic CT imaging, a spherical mass was seen in the right side of the neck. (E) Hematoxylin and eosin staining (×100 magnification) showed lymphoid infiltration. (F) EBV-encoding region in situ hybridization (×200 magnification) showed a positive result.
FIGURE 2 ROC curve. The AUC of the ROC curve was 0.923 (95% confidence interval, 0.834–1.000). The cut-off value at the maximum value of Youden’s index was 0.264, and the sensitivity and specificity were 93.6% and 94.7%, respectively.
FIGURE 3 False-positive and false-negative cases. (A–F) False-positive case. A 7-month-old boy received pLT for biliary atresia.18F-FDG PET/CT imaging was performed 8 months after the operation due to lymphadenopathy. Key findings of the18F-FDG PET/CT scan report include the following. First, the top and posterior walls of the nasopharynx were thickened, and the metabolism was abnormally increased. Second, there were multiple cervical enlarged lymph nodes and abnormal metabolism; the above considerations are consistent with PTLD. (A and B) Maximum-intensity projection and fusion of 18F-FDG PET/CT at the lymph node biopsy site. (C) Axial fusion 18F-FDG PET/CT imaging showed high uptake in the right cervical lymph node. (D) During diagnostic CT imaging, a spherical mass was seen in the right side of the neck. (E) Hematoxylin and eosin staining (×100 magnification) showed lymphoid infiltration. (F) EBV-encoding region in situ hybridization (×200 magnification) showed a negative result. (G–L) False-negative case. A 5-month-old boy received pLT for biliary atresia.18F-FDG PET/CT imaging was performed 8 months after the operation due to long-term fever and lymphadenopathy. Key findings of the 18F-FDG PET/CT scan report include the following. First, there were multiple enlarged lymph nodes in the cervical, mediastinum (anterior trachea), bilateral axial, retroperitoneal autonomous aorta and bilateral inguinal areas, with increased metabolism to varying degrees. Second, the wall of the nasopharynx was significantly thickened, and the metabolism was abnormally increased. Third, the soft tissue nodule under the right diaphragm in the abdominal cavity exhibited an abnormally increased metabolism; these findings were consistent with PTLD. (G and H) Maximum-intensity projection and fusion of 18F-FDG PET/CT at the lymph node biopsy site. (I) Axial fusion18F-FDG PET/CT imaging showed high uptake in the inguinal lymph node. (J) During diagnostic CT imaging, a spherical mass could be seen in the groin. (K) Hematoxylin and eosin staining (×100 magnification) showed lymphoid infiltration. (L) EBV-encoding region in situ hybridization (×200 magnification) showed a positive result.