Recurrent renal cell carcinoma: clinical and prognostic value of FDG PET/CT

Abstract

FDG PET/CT is a valuable tool both in treatment decision-making and for predicting survival and progression in patients affected by RCC.

Comparison of 18F-FDG PET/CT and ceCT Results in the Assessment of RCC Recurrence

“…These foci were lymph nodes in 2 patients and suspected lesion in the renal fossa in 1 patient. Due to the limitations in resolution of PET systems, lesions <1cm may not be detectable by 18 F-FDG PET/CT [19,21]. However, all of these 3 lesions were >1cm and none of them were FDG avid.…”

“…18 F-FDG PET which is a functional imaging modality, also has limited sensitivity for evaluating metastatic RCC, especially for milimetric metastatic lesions [11,13,14]. Nowadays, 18 F-FDG PET/CT that is a hybrid imaging modality, is a promising method for restaging of RCC [15][16][17][18][19][20][21]. In this study, we compared the results of 18 F-FDG PET/ CT and ceCT in patients who had suspected lesions in ceCT for local recurrence and/or distant metastases.…”

“…This reminds us the fact that 18 F-FDG PET/CT is more important in the follow up of patients with high risk for distant metastasis. When the subgroup analysis of the patients with distant metastasis was made, the highest compatibility ratios between ceCT and 18 F-FDG PET/ CT was detected in distant lymph nodes (Kappa:0.70), lung Lung metastasis of RCC is frequently present in 0.5 to 2 cm diameter, well-defi ned, solitary or multiple asymptomatic nodules [21]. Nodule size is an important in evaluation of lung metastasis.…”

Time to reconsider FDG-PET/CT for local and distant staging of urological malignancies

“…FDG-PET/CT seems to perform better in local lymph node staging and restaging when compared to standard procedures (ceCT and MRI), especially in cases of suspected distant spread. Moreover, in the era of molecular-targeted therapies, FDG uptake can play a role in predicting overall survival in RCC and is an excellent tool for the evaluation of responses to therapy with new drugs, such as tyrosine-kinase inhibitors [2]; the RCC response to tyrosine kinase inhibitors, evaluated using FDG-PET/CT to measure tumor size and FDG uptake after 1 month, can predict progression free survival and overall survival.The use of FDG-PET/CT in the diagnosis of upper tract urinary carcinomas (UTUC) has grown slowly compared to its use in other cancer types, although the emergence of PET/ CT as a standard procedure has boosted its role in this setting. FDG-PET/CT seems to be highly sensitive (84 % for cancer [pT2) with a 95 % positive predictive value.…”

“…FDG-PET/CT seems to perform better in local lymph node staging and restaging when compared to standard procedures (ceCT and MRI), especially in cases of suspected distant spread. Moreover, in the era of molecular-targeted therapies, FDG uptake can play a role in predicting overall survival in RCC and is an excellent tool for the evaluation of responses to therapy with new drugs, such as tyrosine-kinase inhibitors [2]; the RCC response to tyrosine kinase inhibitors, evaluated using FDG-PET/CT to measure tumor size and FDG uptake after 1 month, can predict progression free survival and overall survival.…”