PSMA-PET/CT in Patients with Recurrent Clear Cell Renal Cell Carcinoma: Histopathological Correlations of Imaging Findings

Abstract

PET/CT with prostate-specific membrane antigen (PSMA)-targeted tracers has been used in the diagnosis and staging of patients with clear cell renal cell carcinoma (ccRCC). For ccRCC primary tumors, PET parameters were shown to predict histologic grade and features. The aim of this study was to correlate PSMA PET/CT with histopathological findings in patients with metastatic recurrence of ccRCC. Patients with ccRCC who underwent PSMA-targeted PET/CT and subsequent histopathological evaluation of suspicious lesions were included. Specimens underwent immunohistochemical marking. Lesion diameter, volume and tracer uptake were correlated with the extent and intensity of molecular PSMA expression and with clinical findings. Twelve PET-positive lesions of nine patients were evaluated. Eleven ccRCC metastases and one prostate carcinoma were detected histopathologically. Molecular PSMA expression was detected in all lesions, which intensity and distribution did not correlate with PET parameters. PSMA-targeted PET/CT is a feasible tool for the evaluation of patients with ccRCC but cannot reliably predict histologic features of metastases. PSMA may also be expressed in malignant lesions other than ccRCC, leading to incidental detection of these tumors.

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

“…Günhe et al looked into the correlation of PSMA PET results and antigen expression in metastatic ccRCC. PSMA expression was confirmed with immunohistochemistry in all metastatic lesions, although intensity and distribution did not correlate with PET parameters [ 30 ]. The authors of this study concluded that despite the value of PSMA PET in the clinical evaluation of these patients, it cannot reliably predict histologic features of metastases.…”

Application of PET/CT in Preoperative Evaluation and Diagnosis of Gastric Cancer

“…However, the application of pet clinical examination imaging technology can show the erosive lesions, atrophic lesions and diffuse lesions through imaging. The application of PET imaging in gastric cancer is also discussed in the study on the relationship between PET/CT imaging and the expression of HER2 and MDR1 in gastric cancer published by [ 11 , 12 ].…”

Role of PSMA-ligands imaging in Renal Cell Carcinoma management: current status and future perspectives

“…In patients with metastatic disease, PSMA PET/CT has demonstrated a very high detection rate (Rowe et al 2015 ; Meyer et al 2019 ; Raveenthiran et al 2019 ; Gühne et al 2021 ). In this subset of patients, a possible future role for PSMA imaging may be in the therapy response evaluation.…”

“…More recently, Guhne and colleagues (Gühne et al 2021 ) correlated [ 68 Ga]-PSMA PET/CT uptake and histopathological findings in 9 patients with suspect metastatic recurrence of ccRCC. Eleven PSMA-positive lesions were confirmed as metastases from RCC, while 1 lesion resulted from prostate cancer.…”