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


ABSTRACT:

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.

SUBMITTER: Hou G 

PROVIDER: S-EPMC7908760 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Publications

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

Hou Guozhu G   Zhao Dachun D   Jiang Yuanyuan Y   Zhu Zhaohui Z   Huo Li L   Li Fang F   Cheng Wuying W  

Cancer imaging : the official publication of the International Cancer Imaging Society 20210225 1


<h4>Purpose</h4>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.<h4>Methods</h4>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 ret  ...[more]

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