18F-FDG-PET/CT in potentially advanced renal cell carcinoma: a role in treatment decisions and prognosis estimation

Anticancer Res. 2013 Jun;33(6):2665-72.

Abstract

Aim: to assess the influence of positron emission tomography/computed tomography with (18)F-fluorodeoxyglucose ((18)F-FDG-PET/CT) on the treatment decision in renal cell carcinoma and to assess the prognostic value of the (18)F-FDG accumulation assessments.

Patients and methods: Data from 60 patients were included. The cohort consisted of 43 males, 17 females, mean age 66.2 years (range=49-86 years). All patients underwent (18)F-FDG-PET/CT including two-phase CT-angiography of the kidneys. Locally advanced or generalized renal cell carcinoma was suspected in all patients. The level of the (18)F-FDG accumulation within the tumor was compared with the histological grading and the development of the disease was assessed 12 months after (18)F-FDG-PET/CT.

Results: Overall mortality reached 46.7%, the highest (18)F-FDG accumulation showed tumor of grade 4 (mean SUV(max)=10.7, range=5-23), the highest mortality was found for tumors exceeding SUV(max) value of 10 (mortality 62.5%). New information was brought by (18)F-FDG-PET/CT in 85% of cases.

Conclusion: (18)F-FDG-PET/CT has the potential to estimate the patient's survival according to the (18)F-FDG accumulation measured in SUV(max). Depiction of occult metastatic disease has an emerging role in decision making regarding surgery.

Keywords: 18F-FDG-PET/CT; Renal cell carcinoma; SUVmax; hybrid imaging; prognosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angiography
  • Carcinoma, Renal Cell / diagnostic imaging*
  • Carcinoma, Renal Cell / mortality
  • Carcinoma, Renal Cell / pathology
  • Female
  • Fluorodeoxyglucose F18
  • Humans
  • Kidney / diagnostic imaging
  • Kidney Neoplasms / diagnostic imaging*
  • Kidney Neoplasms / mortality
  • Kidney Neoplasms / pathology
  • Male
  • Middle Aged
  • Multimodal Imaging*
  • Neoplasm Grading
  • Positron-Emission Tomography*
  • Prognosis
  • Radiopharmaceuticals
  • Survival Analysis
  • Tomography, X-Ray Computed*

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18