Complimentary Pattern of Uptake in 18F-FDG PET/CT and 68Ga–Prostate-Specific Membrane Antigen PET/CT in a Case of Metastatic Clear Cell Renal Carcinoma

Abstract

We describe a case of metastatic clear cell renal cell carcinoma with intensely tracer concentrating lesions in left suprarenal region, mediastinal lymph nodes, lytic bone lesions, thyroid nodules, and mild abnormal tracer-avid lung nodules in Ga-prostate-specific membrane antigen (PSMA) PET/CT. On the other hand F-FDG PET/CT showed mild to no significant abnormal uptake in these lesions. Complimentary uptake pattern was observed in Ga-PSMA and F-FDG PET images in thyroid lesions and D5 vertebral lesion. This case highlights the possibilities of imaging clear cell renal cell carcinoma with Ga-PSMA and opens the possibility of treatment with Lu-PSMA.

Special issue “The advance of solid tumor research in China”: 68Ga‐PSMA‐11 PET/CT for evaluating primary and metastatic lesions in different histological subtypes of renal cell carcinoma

“…To the best of our knowledge, only few case reports and series in which the role of 68Ga-PSMA-11 PET/CT in RCC staging have been published. [14][15][16][17][18][19][20][21] Our aim was to explore the potential use of Ga-PSMA-11 PET/CT. CT, computed tomography; 68 Ga, gallium-68; multiple M, multiple metastases; MRI, magnetic resonance imaging; Oligo M, oligometastases; PSMA, prostate-specific membrane antigen; PET, positron emission tomography Ga-PSMA-11 PET/CT in the detection of primary and metastatic lesions in different subtypes of RCC for the guidance of diagnostic and management decisions compared with conventional imaging.…”

“…[10][11][12][13] More recently, the clinical use of 68 Ga-PSMA-11 PET/CT for the improved detection of RCC lesions has gained interest, as is clear from the publication of several case reports and retrospective studies with small samples. [14][15][16][17][18][19][20][21] However, the difference in detection rates of primary and metastatic lesions by 68 Ga-PSMA-11 PET/CT in RCC remains unclear, and its clinical indications for RCC are yet to be identified. Thus, we aimed to explore the role of 68 Ga-PSMA-11 PET/CT in the detection of primary and metastatic lesions in different histological subtypes of RCC.…”

“…Positron emission tomography (PET) with ligands of PSMA (eg, 68 Ga‐PSMA‐11) is a relatively new nuclear imaging modality with great potential, and has been applied in prostate cancer management 10‐13 . More recently, the clinical use of 68 Ga‐PSMA‐11 PET/CT for the improved detection of RCC lesions has gained interest, as is clear from the publication of several case reports and retrospective studies with small samples 14‐21 …”

PSMA PET/CT in Renal Cell Carcinoma: An Overview of Current Literature

“…Besides response monitoring in mRCC patients, some groups go even further by suggesting the use of the PSMA antigen as a target for radioligand therapy with lutetium-177-labeled PSMA ligands [ 8 , 32 , 39 ]. Although this is a fascinating concept, it is as yet unclear which patients should be selected for such an approach.…”

Imaging of Nonprostate Cancers Using PSMA-Targeted Radiotracers: Rationale, Current State of the Field, and a Call to Arms

“…At least a dozen metastatic clear cell RCC cases have been published with a variety of PSMA-targeted PET radiotracers ( 111 In-J591, 68 Ga-PSMA-HBED-CC, and 18 F-DCFPyL [2-(3-(1carboxy-5-[(6-18 F-fluoro-pyridine-3-carbonyl)-amino]-pentyl)-ureido)pentanedioic acid]). Uptake has been demonstrated in primary tumors, lymph nodes, and bone metastases, with reported SUVs ranging between 1.7 and 35 (23,(57)(58)(59)(60)(61)(62)(63).…”