Evaluation of renal cell carcinoma histological subtype and fuhrman grade using 18F-fluorodeoxyglucose-positron emission tomography/computed tomography

Abstract

• FDG accumulation reflects tumour aggressiveness and correlates with Fuhrman grade. • FDG-PET/CT enables the differentiation of high- and low-grade ccRCC and pRCCs. • FDG-PET/CT may valuable in the identification of some high-grade RCCs.

Papillary renal cell carcinomas rewire glutathione metabolism and are deficient in anabolic glucose synthesis

“…This pathway is also regarded as an essential process for tumor cell growth (29), since biosynthetic reactions in cancer cells are highly dependent on glycolytic intermediates (30). The kidney may be nearly as important as the liver in gluconeogenesis (31) and pRCCs have been shown to moderately accumulated glucose, which further increases the already higher Fuhrman grades (32). This might be the reason why pRCCs reduce this endergonic pathway, since enough glucose can be imported.…”

A risk‐based approach to identifying oligometastatic disease on imaging

“…High SUV as an independent biomarker of prognosis has been borne out in lung cancer (meta‐analysis of 21 lung cancer studies had a combined hazard ratio of 2.08), in breast cancer (hazard ratio 2.39) and in soft‐tissue sarcoma (hazard ratio 3.75), where it has been related to mitotic count . In renal cell cancer, the apparent diffusion coefficient (ADC) derived from diffusion‐weighted MRI and SUV max from 18 FDG‐PET have been shown to be statistically significant independent risk factors for high histological grade and hence of metastatic risk …”

“…37 In renal cell cancer, the apparent diffusion coefficient (ADC) 38 derived from diffusion-weighted MRI and SUV max from 18 FDG-PET have been shown to be statistically significant independent risk factors for high histological grade and hence of metastatic risk. 39 Heterogeneity of morphological and functional imaging features is proving of interest in predicting metastatic risk. Although the data from 18 FDG PET remains controversial 40,41 entropy measures from histogram analyses of MRI based tumour ADC can predict positive nodal status in rectal cancers 42 and in gastric cancers, while in soft-tissue sarcomas, first order statistics from ADC, which relate to signal variability and to entropy and dissimilarity, were higher in high grade tumours.…”

“…Angiogenic features, maximum standardised uptake value on FDG-PET, apparent diffusion coefficient on MRI are all linked to tumour grade and metastatic risk, [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] but no evidence for their use in distinguishing OM from PM…”

PET/CT and urinary cancers: the message from urologists

“…Preliminary research on 18 F-FDG PET/ CT highlighted the potentials of this technology to differentiate clear cell carcinoma from other tumor types. In particular, 18 F-FDG PET/CT seems to differentiate clear cell carcinomas from less aggressive phenotype or different Fuhrman grade avoiding the use of a percutaneous kidney biopsy [2].…”