{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T18:17:00Z","timestamp":1788373020362,"version":"build-2803163510"},"reference-count":30,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005627","name":"Universit\u00e9 de Li\u00e8ge","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005627","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002661","name":"Fonds De La Recherche Scientifique - FNRS","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002661","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Subclinical kidney allograft acute rejection (SCR) corresponds to \u201cthe unexpected histological evidence of acute rejection in a stable patient\u201d. The diagnosis of SCR relies on surveillance biopsy. Positron emission tomography (PET\/CT) after injection of F\n                      <jats:sup>18<\/jats:sup>\n                      -fluorodeoxyglucose ([\n                      <jats:sup>18<\/jats:sup>\n                      F]FDG) has been proposed as a non-invasive screening approach. In the present multicenter prospective study, we assess the diagnostic yield [\n                      <jats:sup>18<\/jats:sup>\n                      F]FDGPET\/CT to rule out SCR in stable KTR at 3 months\n                      <jats:italic>post<\/jats:italic>\n                      KTx.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      From 01\/2021\u201303\/2025, we prospectively combined surveillance biopsy and [\n                      <jats:sup>18<\/jats:sup>\n                      F]FDGPET\/CT at ~3 months\n                      <jats:italic>post<\/jats:italic>\n                      transplantation in adult kidney transplant recipients from 4 independent imaging centers. The mean standardized uptake value (mSUV) was measured in kidney cortex and referenced as a ratio to psoas muscle mSUV (mSUVR).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Our multicenter cohort of 185 patients was categorized according to the Banff-2022 classification as: normal (n\u2009=\u2009158); borderline (n\u2009=\u200918); SCR (n\u2009=\u20099, including 6 T-cell-mediated rejection and 3 microvascular inflammation). No significant correlation was observed between the mSUVR and ti score (R\u2009=\u20090.032, p-value\u2009=\u20090.67). The mSUVR reached 2.33 [1.97\u20132.93], 2.71 [2.50\u20133.33] and 2.42 [2.27\u20133.14] in normal, borderline and SCR groups, respectively. In multivariate models stratified by center, the risk of non-normal histology (n\u2009=\u200927, including borderline and SCR) increased with donor age (OR=1.05 [1.01\u20131.1], p\u2009=\u20090.02) but not with the mSUVR (OR=4.11 [0.91\u201318.48], p\u2009=\u20090.07). The Z-score of mSUVR was significantly associated with the risk of non-normal histology (OR=1.542 [1.02\u20132.33, p\u2009=\u20090.04). The risk of biopsy-proven SCR (n\u2009=\u20099) was not significantly associated with mSUVR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      The mSUVR of [\n                      <jats:sup>18<\/jats:sup>\n                      F]FDG PET\/CT does not reliably rule out SCR on surveillance biopsy.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0345426","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T17:48:43Z","timestamp":1788371323000},"page":"e0345426","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["A multicenter prospective validation cohort does not support the use of kidney\/psoas [18F]FDG uptake in the diagnosis of kidney allograft subclinical rejection"],"prefix":"10.1371","volume":"21","author":[{"given":"Pierre","family":"Lovinfosse","sequence":"first","affiliation":[{"name":"University of Li\u00e8ge Hospital","place":["Li\u00e8ge, Belgium"],"department":["Division of Nuclear Medicine, Department of Medical Physics"]},{"name":"GIGA Institute, in vivo Imaging","place":["Li\u00e8ge, Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Bouquegneau","sequence":"additional","affiliation":[{"name":"University of Li\u00e8ge Hospital","place":["Li\u00e8ge, Belgium"],"department":["Division of Nephrology, Department of Internal Medicine"]},{"name":"GIGA Institute, Metabolism & Cardiovascular Biology, University of Li\u00e8ge","place":["Li\u00e8ge, Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annick","family":"Massart","sequence":"additional","affiliation":[{"name":"Universitair Ziekenhuis Antwerpen","place":["Antwerp, Belgium"],"department":["Division of Nephrology, Department of Internal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lissa","family":"Pipeleers","sequence":"additional","affiliation":[{"name":"Universitair Ziekenhuis Brussel, Vrije Universiteit","place":["Brussels, Belgium"],"department":["Department of Nephrology and Arterial Hypertension"]},{"name":"Vitality Research Group, Vrije Universiteit","place":["Brussels, Belgium"],"department":["Kidney Diseases, Dialysis & Transplantation Research Unit (NIER)"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Bonvoisin","sequence":"additional","affiliation":[{"name":"University of Li\u00e8ge Hospital","place":["Li\u00e8ge, Belgium"],"department":["Division of Nephrology, Department of Internal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurens","family":"Carp","sequence":"additional","affiliation":[{"name":"Universitair Ziekenhuis Antwerpen","place":["Antwerp, Belgium"],"department":["Division of Nuclear Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hendrik","family":"Everaert","sequence":"additional","affiliation":[{"name":"Universitair Ziekenhuis Brussel","place":["Brussels, Belgium"],"department":["Division of Nuclear Medicine, Department of Medical Physics"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre","family":"Jadoul","sequence":"additional","affiliation":[{"name":"University of Li\u00e8ge Hospital","place":["Li\u00e8ge, Belgium"],"department":["Division of Nuclear Medicine, Department of Medical Physics"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Am\u00e9lie","family":"Dendooven","sequence":"additional","affiliation":[{"name":"University of Antwerp","place":["Antwerp, Belgium"],"department":["Faculty of Health Sciences"]},{"name":"university Hospital of Ghent","place":["Ghent, Belgium"],"department":["Department of Pathology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Geers","sequence":"additional","affiliation":[{"name":"Universitair Ziekenhuis Brussel","place":["Brussels, Belgium"],"department":["Division of Renal Pathology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"St\u00e9phanie","family":"Grosch","sequence":"additional","affiliation":[{"name":"University of Li\u00e8ge Hospital","place":["Li\u00e8ge, Belgium"],"department":["Division of Nephrology, Department of Internal Medicine"]},{"name":"Unilab, University of Li\u00e8ge Hospital","place":["Li\u00e8ge, Belgium"],"department":["Division of Renal Pathology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pauline","family":"Erpicum","sequence":"additional","affiliation":[{"name":"University of Li\u00e8ge Hospital","place":["Li\u00e8ge, Belgium"],"department":["Division of Nephrology, Department of Internal Medicine"]},{"name":"GIGA Institute, Metabolism & 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