Renal Cell Cancer and Positron Emission Tomography- an Evolving Diagnostic and Therapeutic Relationship

Abstract

The incidence of Renal Cell Carcinoma (RCC) is increasing at all stages. Thus, there is a need to develop more accurate and reliable methods of diagnosing, staging and treating the disease. The role of positron emission tomography (PET) is still evolving with regard to the diagnosis, staging and management of RCC. At present, the assessment of renal masses and primary staging of RCC are reasonably well investigated using computed tomography and ultrasound. However, many masses are still excised that are benign or understaged. PET with 18 F-Fluorodeoxyglucose (FDG) has been useful with re-staging RCC and in certain cases where conventional studies, including bone scan, are inconclusive. The value of PET radiotracers in RCC other than FDG, the standard one used in oncology, is under investigation. We review the current status of PET in RCC and examine the recent development of PET/CT with its impact on renal mass imaging due to its ability to contemporaneously acquire and co-register data, to localize elevated FDG uptake with improved anatomic specificity. New radiotracers, such as those created by radiolabelling of antibodies (e.g. labelled G250, a protein overexpressed in RCC cells) and how they may impact on the diagnosis and future treatment of RCC are also outlined.