Diagnostic value of F-18 FDG PET/CT for local and distant disease relapse surveillance in surgically treated RCC patients: Can it aid in establishing consensus follow up strategy?

Elahmadawy, Mai Amr; Elazab, Mohamed Samy Saied; Ahmed, Soha; Salama, Mohamed

doi:10.5603/nmr.2018.0024

Cited by 19 publications

(11 citation statements)

References 19 publications

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“…18) For high-risk patients, the European Association for Urology (EAU) guidelines recommend the first CT six months after surgery and, subsequently, once a year up to three years and every two years afterwards. A recent report by Elahmadawy et al, 19) about detection of local and distant disease relapse in surgically treated patients with RCC, indicated that local and/or distant disease relapse was confirmed in 72% of patients. Regarding local recurrence, fluorodeoxyglucose positron emission tomographycomputed tomography (FDG PET-CT) showed specificity of 100%, compared to 98.6% with contrast-enhanced CT (P>0.05) and higher sensitivity noted with contrast-enhanced CT (100%) compared to 96% with FDG PET-CT.…”

Section: Discussionmentioning

confidence: 99%

Surgical Interventions for Renal Cell Carcinoma with Thrombus Extending into the Inferior Vena Cava: A Multidisciplinary Approach

Rehman

Ather

Aziz

2019

Annals of Vascular Diseases

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Objective: To assess surgical strategies and the impact of a multidisciplinary approach on patients undergoing inferior vena caval thrombectomy for renal cell carcinoma and to evaluate perioperative morbidity and mortality associated with these procedures.Methodology: A retrospective audit for all adults who underwent nephrectomy and inferior vena caval thrombectomy from January 2008 till November 2018 at a University hospital. Patients with incomplete records were excluded from the study.Results: During the study period, 21 patients underwent inferior vena caval thrombectomy as a completion of radical nephrectomy. Most were males (19 : 2) with a mean age of 54±11.3 years. The most common surgical approach was the 11th rib flank approach (n=8) followed by midline abdominal (n=6) and Mercedes-Benz (n=5). Eight patients had level 1, 10 patients had level 2, and three patients had level 3 tumour thrombus. The cavotomy was closed primarily in 20 patients; one required inferior vena cava (IVC) reconstruction with a pericardial patch. The proximal clamp was applied below the hepatic veins for most patients. Two patients required suprahepatic clamping before thrombectomy. There was no intraoperative mortality. Five patients (24%) developed complications: two required cardiopulmonary resuscitation due to severe hypotension and were revived; one developed acute renal failure; and one patient required a damage control laparotomy for excessive oozing. There was no thirty-day mortality.Conclusion: The IVC thrombectomy, along with radical nephrectomy for renal cell carcinoma for 1–3 level thrombus, can be performed with acceptable morbidity in a multidisciplinary team approach.

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Section: Discussionmentioning

confidence: 99%

Surgical Interventions for Renal Cell Carcinoma with Thrombus Extending into the Inferior Vena Cava: A Multidisciplinary Approach

Rehman

Ather

Aziz

2019

Annals of Vascular Diseases

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“…Furthermore, PET/CT has been implicated as a potentially helpful instrument in monitoring the therapeutic response to ICIs in mRCC. It was also emphasized that PET/CT determines and evaluates skeletal metastases more sensitively and accurately than conventional methods [16].…”

Section: Discussionmentioning

confidence: 99%

Role of 18F-FDG PET/CT in the assessment of therapy response and clinical outcome in metastatic renal cell carcinoma treated with tyrosine kinase inhibitors or immunotherapy

Tatar

Alçin

Samancı

et al. 2022

Nuclear Medicine Communications

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Objective This study aimed to determine the role and prognostic significance of 18 F-FDG PET/CT on treatment response and survival outcomes in metastatic renal cell carcinoma patients treated with immunotherapy or tyrosine kinase inhibitors (TKIs). Patients and methodsForty patients scheduled for a standard treatment protocol with TKIs (n = 17; group-1) or PD-1 inhibitors (nivolumab, n = 23; group-2) were evaluated by 18 F-FDG PET/CT. Peak standardized uptake value corrected for lean body mass (SUL peak ) and maximum standardized uptake value (SUV max ) were calculated, and their relationship to treatment response was evaluated. ResultsComplete response (CR) in three patients, partial response (PR) in two patients and stable disease (SD) in eight patients were observed in group-1, and the results were as follows for group-2: PR in seven and SD in five patients. At a mean of 17.5-month observation period (range, 7-47), 35.2% of patients progressed, and 23.5% achieved a CR, and no recurrence was observed on PET/ CT scans during follow-up. Among all patients enrolled in the study, the 5-year OS in patients with progressive disease (PD) was significantly shorter than patients with clinical benefit (CB = CR and PR and SD) (P = 0.016).Significant differences in both ΔSUL peak and ΔSUV max were found between PD versus CB (P = 0.001 and P < 0.001, respectively). Conclusion 18 F-FDG-PET/CT can accurately assess therapy response and predict patient outcome in metastatic RCC. 18 F-FDG PET/CT may facilitate patient management by evaluating the biological and immunological responses to treatment in patients treated with TKIs or ICIs.

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“…Sensitivity and specificity ranging from 63% to 75% and from 90% to 100%, respectively, have been reported in detecting extra renal metastases when FDG PET was compared with conventional imaging techniques such as the CECT scan. [ 32 33 ] One of the most important factors affecting the sensitivity of PET/CT is the size of the lesion, with smaller lesions being more difficult to pick up as compared to the larger ones. Sensitivity increases from 73% to 90% when the lesion size increases from 1 to 2 cm and in patients with a true positive FDG PET, the mean size of the distant metastases was 2.2 cm (95% confidence interval, 1.7–2.6 cm) compared with 1.0 cm in the patients with false negative FDG PET.…”

Section: Discussionmentioning

confidence: 99%

Role of positron emission tomography/computed tomography in the evaluation of renal cell carcinoma

et al. 2021

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Introduction: Positron emission tomography (PET) is not a standard recommendation in most of the major guidelines for the evaluation of renal cell carcinoma (RCC). Earlier studies evaluating PET scan in patients with RCC have provided discordant results. However, with the advent of newer hybrid PET/computed tomography (CT) scanning systems, this modality has shown increased efficacy in the evaluation of primary renal masses along with the detection of extrarenal metastases, restaging recurrent RCC, and also in monitoring response to targeted therapy. We performed a systematic review of the existing literature on the role of PET scan in the evaluation of RCC. Methodology: We systematically searched the databases of PubMed/Medline, Embase, and Google Scholar to identify studies on the use of PET scan in RCC. Using Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines, 94 full-text articles were selected, of which 54 relevant articles were then reviewed, after a consensus by the authors. Results: Several studies have shown similar sensitivity and specificity of fluoro-2-deoxy-2-d-glucose-PET (FDG-PET) scan as compared to conventional CT scan for the initial diagnosis of RCC, and an improved sensitivity and specificity for the detection of metastases and recurrences following curative therapy. The PET scan may also play a role in predicting the initial tumor biology and pathology and predicting the prognosis as well as the response to therapy. Conclusion: The current guidelines do not recommend PET scan in the staging armamentarium of RCCs. However, FDG-PET scan is as efficacious, if not better than conventional imaging alone, in the evaluation of the primary and metastatic RCC, as well as in evaluating the response to therapy, due to its ability to pick up areas of increased metabolic activity early on. Newer tracers such as Ga 68 prostate specific membrane antigen-labeled ligands may help in opening up newer avenues of theragnostics.

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Diagnostic value of F-18 FDG PET/CT for local and distant disease relapse surveillance in surgically treated RCC patients: Can it aid in establishing consensus follow up strategy?

Abstract: FDG PET-CT appears to be a very efficient tool in post-surgical surveillance of patients with RCC with notable ability to probe even uncommon sites of distant recurrence.

Cited by 19 publications

References 19 publications

Surgical Interventions for Renal Cell Carcinoma with Thrombus Extending into the Inferior Vena Cava: A Multidisciplinary Approach

Surgical Interventions for Renal Cell Carcinoma with Thrombus Extending into the Inferior Vena Cava: A Multidisciplinary Approach

Role of 18F-FDG PET/CT in the assessment of therapy response and clinical outcome in metastatic renal cell carcinoma treated with tyrosine kinase inhibitors or immunotherapy

Role of positron emission tomography/computed tomography in the evaluation of renal cell carcinoma

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