18F-FPPRGD2 PET/CT in patients with metastatic renal cell cancer

  • Akira Toriihara
  • Heying Duan
  • Holly M. Thompson
  • Sonya Park
  • Negin Hatami
  • Lucia Baratto
  • Alice C. FanEmail author
  • Andrei IagaruEmail author
Short Communication



The usefulness of positron emission tomography/computed tomography (PET/CT) using (18F)-2-fluoropropionyl-labeled PEGylated dimeric arginine-glycine-aspartic acid peptide [PEG3-E{c(RGDyk)}2] (18F-FPPRGD2) in patients with metastatic renal cell cancer (mRCC) has not been evaluated; therefore, we were prompted to conduct this pilot study.


Seven patients with mRCC were enrolled in this prospective study. 18F-FPPRGD2 and 2-deoxy-2-(18F)fluoro-D-glucose (18F-FDG) PET/CT images were evaluated in a per-lesion analysis. Maximum standardized uptake value (SUVmax) and tumor-to-background ratio (T/B) were measured for all detected lesions, both before and after starting antiangiogenic therapy.


Sixty lesions in total were detected in this cohort. SUVmax from 18F-FPPRGD2 PET/CT was lower than that from 18F-FDG PET/CT (4.4 ± 2.9 vs 7.8 ± 5.6, P < 0.001). Both SUVmax and T/B from 18F-FPPRGD2 PET/CT decreased after starting antiangiogenic therapy (SUVmax, 4.2 ± 3.2 vs 2.6 ± 1.4, P = 0.003; T/B, 3.7 ± 3.2 vs 1.5 ± 0.8, P < 0.001). Average changes in SUVmax and T/B were − 29.3 ± 23.6% and − 48.1 ± 28.3%, respectively.


18F-FPPRGD2 PET/CT may be an useful tool for monitoring early response to antiangiogenic therapy in patients with mRCC. These preliminary results need to be confirmed in larger cohorts.


Renal cell cancer 18F-FPPRGD2 18F-FDG PET/CT Antiangiogenic therapy 



The study was supported by a grant to Dr. Holly M. Thompson from Alpern Foundation. Alice C. Fan receives funding support from ASCO Conquer Cancer Foundation Career Development Award and is a founder of Molecular Decisions Inc. Andrei Iagaru receives institutional research support from GE Healthcare.

Compliance with ethical standards

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Conflict of interest

Alice C. Fan receives funding support from ASCO Conquer Cancer Foundation Career Development Award and is a founder of Molecular Decisions Inc.

Andrei Iagaru receives institutional research support from GE Healthcare (unrelated to this study).

Supplementary material

259_2019_4295_MOESM1_ESM.pdf (124 kb)
ESM 1 (PDF 123 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of Nuclear Medicine and Molecular Imaging, Department of RadiologyStanford UniversityStanfordUSA
  2. 2.Department of Nuclear MedicineKaiser PermanenteSanta ClaraUSA
  3. 3.Division of Oncology, Department of MedicineStanford UniversityStanfordUSA

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