Koya Nakatani1, Yuji Nakamoto, Tsuneo Saga, Tatsuya Higashi, Kaori Togashi. 1. Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-kawahara-cho, Sakyo-Ku, Kyoto 606-8507, Japan. koyakn@kuhp.kyoto-u.ac.jp
Abstract
PURPOSE: The clinical value of positron emission tomography (PET) using (18)F-fluorodeoxyglucose (FDG) for follow-up or suspected recurrence of renal cell carcinoma (RCC) has not been fully evaluated. The purpose of this study was to assess the diagnostic performance of FDG-PET for postoperative assessment in patients with RCC. METHODS: We reviewed 28 scans in 23 patients who had undergone FDG-PET scans after surgery for RCC. Diagnostic accuracy of visually interpreted PET was evaluated based on final diagnoses obtained histologically or by clinical follow-up at least 6 months. Also, additional information over CT, influence on treatment decisions, and the accuracy of FDG uptake as a predictor of survival were assessed. RESULTS: Recurrence of renal carcinoma was histologically (n=15) or clinically (n=6) confirmed in 21 of 28 cases. Overall, the sensitivity, specificity, and diagnostic accuracy using FDG-PET were 81%, 71%, and 79%, respectively. In papillary RCC, the sensitivity was 100%; however, that was 75% in clear cell RCC in patient-basis. PET correctly detected local recurrence and metastases in all cases in the peritoneum, bone, muscle and adrenal gland. Additional information was obtained from scans in 6 cases (21%), which influenced therapeutic management in 3 cases (11%). Cumulative survival rates over 5 years in the PET-positive vs. the PET-negative group were 46% vs. 83%, respectively (p=0.17). CONCLUSIONS: FDG-PET would be useful for postoperative surveillance in patients with RCC, although its impact on treatment decisions may be limited. Further investigations are necessary to conclude whether PET has a prognostic value.
PURPOSE: The clinical value of positron emission tomography (PET) using (18)F-fluorodeoxyglucose (FDG) for follow-up or suspected recurrence of renal cell carcinoma (RCC) has not been fully evaluated. The purpose of this study was to assess the diagnostic performance of FDG-PET for postoperative assessment in patients with RCC. METHODS: We reviewed 28 scans in 23 patients who had undergone FDG-PET scans after surgery for RCC. Diagnostic accuracy of visually interpreted PET was evaluated based on final diagnoses obtained histologically or by clinical follow-up at least 6 months. Also, additional information over CT, influence on treatment decisions, and the accuracy of FDG uptake as a predictor of survival were assessed. RESULTS: Recurrence of renal carcinoma was histologically (n=15) or clinically (n=6) confirmed in 21 of 28 cases. Overall, the sensitivity, specificity, and diagnostic accuracy using FDG-PET were 81%, 71%, and 79%, respectively. In papillary RCC, the sensitivity was 100%; however, that was 75% in clear cell RCC in patient-basis. PET correctly detected local recurrence and metastases in all cases in the peritoneum, bone, muscle and adrenal gland. Additional information was obtained from scans in 6 cases (21%), which influenced therapeutic management in 3 cases (11%). Cumulative survival rates over 5 years in the PET-positive vs. the PET-negative group were 46% vs. 83%, respectively (p=0.17). CONCLUSIONS:FDG-PET would be useful for postoperative surveillance in patients with RCC, although its impact on treatment decisions may be limited. Further investigations are necessary to conclude whether PET has a prognostic value.
Authors: Mohammad H Bagheri; Mark A Ahlman; Liza Lindenberg; Baris Turkbey; Jeffrey Lin; Ali Cahid Civelek; Ashkan A Malayeri; Piyush K Agarwal; Peter L Choyke; Les R Folio; Andrea B Apolo Journal: Urol Oncol Date: 2017-05-12 Impact factor: 3.498
Authors: Ricardo A Rendon; Anil Kapoor; Rodney Breau; Michael Leveridge; Andrew Feifer; Peter C Black; Alan So Journal: Can Urol Assoc J Date: 2014-05 Impact factor: 1.862