Early assessment by FDG-PET/CT of patients with advanced renal cell carcinoma treated with tyrosine kinase inhibitors is predictive of disease course

Ueno, Daiki; Yao, Masahiro; Tateishi, Ukihide; Minamimoto, Ryogo; Makiyama, Kazuhide; Hayashi, Narihiko; Sano, Futoshi; Murakami, Takayuki; Kishida, Takeshi; Miura, Takeshi; Kobayashi, Kazuki; Noguchi, Sumio; Ikeda, Ichiro; Ohgo, Yoshiharu; Inoue, Tomio; Kubota, Yoshinobu; Nakaigawa, Noboru

doi:10.1186/1471-2407-12-162

Cited by 68 publications

(58 citation statements)

References 19 publications

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“…Values can diverge from undetectable (below 1.5) to levels over 24.0 (17,18). Regarding the cell subtype of RCC, no correlation in SUV values was found (19). Concerning the relation to tumor size significant difference was observed, but only if lesions were larger than 5 cm (20).…”

Section: Fdg Pet/ct In Evaluation and Staging Of Rcc Patientsmentioning

confidence: 87%

PET/CT in renal and bladder cancers

Balenović¹,

Mihaïlovic²,

Jazvić³

et al. 2012

Arch Oncol

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FDG is the most frequently used positron emission tomography probe but it has certain limitations when used in urological cancers due to its urinary elimination, which prevents the proper visualization of the bladder and kidneys. The introduction of co-registered PET and computed tomography (PET/CT) represents a major advance in technology and now become the new standard for many cancers. For the staging and surveillance of renal cell cancer, FDG PET/ CT had results that were at least as good as conventional methods, which are potentially harmful for the remained renal function. FDG-PET/CT is able to evaluate early response to sunitinib or sorafenib treatment in metastatic renal cell cancer. An early decrease in the mean glucose uptake was found in both soft and skeletal lesions after treatment, thus PET seems to be more advantageous compared with RECIST evaluation. In addition, the survival of patients with advanced renal cell cancer can be predicted by evaluating their SUVmax using FDG-PET/CT. Although urinary bladder cancer demonstrates sufficiently increased FDG uptake, primary tumors are difficult to identify due to the renal excretion of FDG. The accuracy of FDG-PET/CT in metabolically active metastases is generally higher when compared to conventional CT except for identifying small lung deposits. PET/CT with delayed images after a diuretic and oral hydration may improve detection of locally recurrent or residual UBC and could replace standard CT and bone scintigraphy in the presurgical staging and monitoring of patients with urinary bladder cancer. 18F-choline PET may be useful for staging of urinary bladder cancer in addition to FDG PET

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Section: Fdg Pet/ct In Evaluation and Staging Of Rcc Patientsmentioning

confidence: 87%

PET/CT in renal and bladder cancers

Balenović¹,

Mihaïlovic²,

Jazvić³

et al. 2012

Arch Oncol

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“…Previous reports have either failed to predict outcome [7] or have involved evaluation at later timepoints [6,12,13]. Present findings highlight the value of volume-based metabolic parameters (such as SULpeak and TLG) in assessing the response of patients with mRCC by FDG-PET.…”

Section: Discussionmentioning

confidence: 62%

“…A recent investigation using this technique before and after a one-month treatment successfully predicted progression-free survival (PFS) in patients with mRCC [6], but a similar study could only predict overall survival (OS) [7] after 4 months treatment. In both cases the maximal standardized uptake (SUVmax) was the sole FDG-PET parameter utilized as an indicator of metabolism.…”

Section: Introductionmentioning

confidence: 99%

Volumetric FDG-PET predicts overall and progression- free survival after 14 days of targeted therapy in metastatic renal cell carcinoma

et al. 2014

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BackgroundTo determine whether changes in the metabolism of metastatic renal cell carcinoma (mRCC) assessed by F18-FDG-PET after 14 and 28 days of treatment with tyrosine kinase inhibitors can predict overall and progression- free patient survival.MethodsThirty-nine consecutive patients with mRCC were included prospectively and underwent PET examinations prior to and after 14 and 28 days of standard treatment with sunitinib (n = 18), sorafenib (n = 19) or pazopanib (n = 2). The PET response was analyzed in terms of SUVmax, SULpeak, and total lesion glycolysis and a positive response (defined as a 30% reduction) compared to overall and progression- free survival.ResultsThirty-five patients with at least one metabolically active metastatic lesion prior to treatment underwent additional FDG-PET examinations after 14 (n = 32) and/or 28 days (n = 30) of treatment. Changes in either SULpeak or total lesion glycolysis were correlated to both progression-free and overall survival (for TLG2.5 responders, HR = 0.38 (95% CI: 0.18-0.83) and 0.22 (95% CI: 0.09-0.53), and for TLG50 responders, HR = 0.25 (0.10-0.62) and 0.25 (95% CI: 0.11-0.57) and for SULpeak responders, HR = 0.39 (95% CI: 0.17-0.91) and 0.38 (95% CI: 0.15-0.93), respectively). In contrast SUVmax response did not predict progression- free or overall survival (HR = 0.43 (95% CI: 0.18-1.01) and 0.50 (95% CI: 0.21-1.19), respectively).ConclusionsAssessment of early changes in SULpeak and total lesion glycolysis undergoing treatment with tyrosine kinase inhibitors by FDG-PET can possibly predict progression- free and overall survival in patients with mRCC.

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“…In renal cancer, van der Veldt and colleagues have analysed the use of Choi criteria in treatment response assessment in RCC and found them to correlate better to TTP than RECIST [van der Veldt et al 2010]. A total of 55 patients with metastatic RCC treated with sunitinib were analysed retrospectively.…”

Section: Assessment Of Change In Metabolic Activitymentioning

confidence: 99%