Three Primary Carcinomas on 18F-FDG PET/CT

Wu, Dexi; Hu, Yujing; Wei, Qiang; Tian, Congna; Bian, Yanzhu

doi:10.1097/rlu.0000000000002070

Cited by 1 publication

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“…However, to date, studies on the use of FDG PET/CT in RCC predominantly enrolled patients with clear cell RCC [17][18][19][20][21], and only a few studies included a small proportion of papillary RCC [16,22,23]. Research of FDG PET/CT focusing on papillary RCC is scarce and limited to case reports [24][25][26]. This retrospective study aimed, 1) to assess the usefulness of FDG PET/CT in the evaluation of primary and suspected recurrent papillary RCC, 2) to evaluate the prognostic value of staging FDG PET/CT in papillary RCC patients.…”

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confidence: 99%

Clinical utility of FDG PET/CT for primary and recurrent papillary renal cell carcinoma

et al. 2021

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Purpose Papillary renal cell carcinoma (RCC) is the second most common subtype of RCC, after clear cell RCC. This study aimed to investigate the usefulness of FDG PET/CT in primary and recurrent papillary RCC, and the role of staging FDG PET/CT in predicting survival. Methods A total of 66 patients with histopathologically confirmed papillary RCC who underwent either staging or restaging FDG PET/CT scans (30 had staging scans only, 28 had restaging scans only, 8 had both) were retrospectively included in this study. The sensitivity and specificity of restaging FDG PET/CT for detecting recurrence were assessed by histopathology and/or clinical follow-up as standard reference. Results Staging FDG PET/CT scans were performed in 38 patients, of which 31 (81.5%) showed FDG-positive primary renal lesions. The SUVmax of high-grade (WHO grade 3 and 4) papillary RCCs were significantly higher than that of low-grade (WHO grade 1 and 2) tumors (9.44 ± 6.18 vs 4.83 ± 3.19, P = 0.008). The SUVmax was not significantly different between type 1 and type 2 papillary RCCs (5.71 ± 2.88 vs. 6.99 ± 5.57, P = 0.563). Of the 38 patients, 12 developed disease progression during the follow-up period. Patients with primary tumor SUVmax> 5.85 were associated with significantly shorter progression-free survival (PFS) than those with tumor SUVmax≤5.85 (P = 0.005). Restaging FDG PET/CT scans were performed in 36 patients with suspected recurrent papillary RCCs. FDG PET/CT showed a sensitivity and specificity of 100 and 72.7% for detecting recurrent disease. Comparison of PET/CT scans with CT/MRI imaging was available in 23 patients. FDG PET/CT revealed additional findings in 11 patients, mainly including lymph node and bone metastases. FDG PET/CT findings led to change in management in 5.3% (2/38) of patients in the staging setting and 16.7 (6/36) of patients in the restaging setting. Conclusions FDG PET/CT had a sensitivity of 81.5% for detecting primary papillary RCC, and tumor SUVmax derived from staging FDG PET/CT was a predictor of PFS. In the restaging process of papillary RCC, FDG PET/CT was very effective for detecting recurrent disease.

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