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18Fluorodeoxyglucose-positron emission tomography/computed tomography for differentiation of renal tumors in hereditary kidney cancer syndromes

  • Kidneys, Ureters, Bladder, Retroperitoneum
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To assess differences in FDG-PET/CT uptake among four subtypes of renal tumors: clear cell RCC (ccRCC), papillary type I and II RCC (pRCC), and oncocytoma.

Methods

This retrospective study investigated 33 patients with 98 hereditary renal tumors. Lesions greater than 1 cm and patients with a timeframe of less than 18 months between preoperative imaging and surgery were considered. FDG-PET/CT images were independently reviewed by two nuclear medicine physicians, blinded to clinical information. Volumetric lesion SUVmean was measured and used to calculate a target-to-background ratio respective to liver (TBR). The Shrout-Fleiss intra-class correlation coefficient was used to assess reliability between readers. A linear mixed effects model, accounting for within-patient correlations, was used to compare TBR values of primary renal lesions with and without distant metastasis.

Results

The time interval between imaging and surgery for all tumors had a median of 77 (Mean: 139; Range: 1–512) days. Intra-class reliability of mean TBR resulted in a mean κ score of 0.93, indicating strong agreement between the readers. The mixed model showed a significant difference in mean TBR among the subtypes (p < 0.0001). Pairwise comparison showed significant differences between pRCC type II and ccRCC (p < 0.0001), pRCC type II and pRCC type I (p = 0.0001), and pRCC type II and oncocytoma (p = 0.0016). Furthermore, a significant difference in FDG uptake was present between primary pRCC type II renal lesions with and without distant metastasis (p = 0.023).

Conclusion

pRCC type II lesions demonstrated significantly higher FDG activity than ccRCC, pRCC type I, or oncocytoma. These findings indicate that FDG may prove useful in studying the metabolic activity of renal neoplasms, identifying lesions of highest clinical concern, and ultimately optimizing active surveillance, and personalizing management plans.

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Funding

This work was supported by the Intramural Research Programs of the Center for Cancer Research-National Cancer Institute and the National Institutes of Health Clinical Center, Bethesda, Maryland, USA.

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Authors and Affiliations

  1. Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, USA

    Moozhan Nikpanah, Mark A. Ahlman, Faraz Farhadi, Babak Saboury, Elizabeth C. Jones & Ashkan A. Malayeri

  2. Duke University School of Medicine, Durham, NC, USA

    Anna K. Paschall

  3. Division of Nuclear Medicine and Molecular Imaging, Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Ali Cahid Civelek

  4. Geisel School of Medicine at Dartmouth, Hanover, NH, USA

    Faraz Farhadi

  5. Advanced Cardiovascular Imaging Laboratory, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA

    S. Mojdeh Mirmomen

  6. Biostatistics and Epidemiology, Clinical Center, National Institutes of Health, Bethesda, MD, USA

    Xiaobai Li

  7. Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA

    Mark W. Ball, Ramaprasad Srinivasan & W. Marston Linehan

  8. Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA

    Maria J. Merino

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  1. Moozhan Nikpanah
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Correspondence to W. Marston Linehan or Ashkan A. Malayeri.

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Nikpanah, M., Paschall, A.K., Ahlman, M.A. et al. 18Fluorodeoxyglucose-positron emission tomography/computed tomography for differentiation of renal tumors in hereditary kidney cancer syndromes. Abdom Radiol 46, 3301–3308 (2021). https://doi.org/10.1007/s00261-021-02999-9

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  • DOI: https://doi.org/10.1007/s00261-021-02999-9

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