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Inconsistent Detection of Sites of Metastatic Non-Clear Cell Renal Cell Carcinoma with PSMA-Targeted [18F]DCFPyL PET/CT

  • Yafu Yin
  • Scott P. Campbell
  • Mark C. Markowski
  • Philip M. Pierorazio
  • Martin G. Pomper
  • Mohamad E. Allaf
  • Steven P. Rowe
  • Michael A. Gorin
Research Article

Abstract

Purpose

To investigate the utility of prostate-specific membrane antigen (PSMA)-targeted [18F]DCFPyL positron emission tomography (PET)/X-ray computed tomography (CT) imaging for the detection of sites of disease in patients with metastatic non-clear cell renal cell carcinoma (RCC).

Procedures

Eight patients with metastatic non-clear cell RCC underwent imaging with PSMA-targeted [18F]DCFPyL PET/CT. Imaged RCC histologic subtypes included papillary RCC (n = 3), chromophobe RCC (n = 2), unclassified RCC (n = 2), and Xp11 translocation RCC (n = 1). Using comparison to conventional CT and/or magnetic resonance imaging as reference, two radiologists with expertise in nuclear medicine identified putative sites of disease on [18F]DCFPyL PET/CT and classified each lesion as having no radiotracer uptake, equivocal uptake, or definitive uptake.

Resuts

In total, 73 metastatic sites and 3 primary tumors compatible with sites of non-clear cell RCC were identified on conventional imaging. Metastatic sites of disease included lymph nodes (n = 40), venous thrombi (n = 3), pulmonary nodules (n = 10), bone lesions (n = 15), brain lesions (n = 3), and retroperitoneal masses (n = 2). Only 10 of the 73 lesions (13.7 %) were classified as having definitive radiotracer uptake (median SUVmax = 3.25, range = 1.2–9.5), 14 lesions (19.2 %) had equivocal uptake (median SUVmax = 2.85, range = 0.5–6.5), and 49 lesions (67.1 %) had no definitive uptake above background (median SUVmax = 1.7, range = 0.2–3.0). The three primary renal tumors demonstrated lower radiotracer avidity relative to surrounding normal renal parenchyma.

Conclusions

A small proportion of sites of non-clear cell RCC showed uptake of the PSMA-targeted radiotracer [18F]DCFPyL. Unlike for clear cell RCC, the results of this study indicate that PSMA-based PET is not appropriate for imaging other RCC subtypes.

Key words

Prostate-specific membrane antigen Renal cell carcinoma RCC PSMA [18F]DCFPyL 

Notes

Compliance with Ethical Standards

Conflict of Interest

MGP is a co-inventor on a United States Patent covering [18F]DCFPyL and as such is entitled to a portion of any licensing fees and royalties generated by this technology. MAG has served as a consultant to Progenics Pharmaceuticals, the licensee of [18F]DCFPyL. MAG and SPR have received research support from Progenics Pharmaceuticals.

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Copyright information

© World Molecular Imaging Society 2018

Authors and Affiliations

  • Yafu Yin
    • 1
    • 2
  • Scott P. Campbell
    • 3
  • Mark C. Markowski
    • 4
  • Philip M. Pierorazio
    • 3
    • 4
  • Martin G. Pomper
    • 1
    • 3
    • 4
  • Mohamad E. Allaf
    • 3
    • 4
  • Steven P. Rowe
    • 1
    • 3
  • Michael A. Gorin
    • 1
    • 3
    • 4
  1. 1.The Russell H. Morgan Department of Radiology and Radiological ScienceJohns Hopkins University School of MedicineBaltimoreUSA
  2. 2.Department of Nuclear MedicineThe First Hospital of China Medical UniversityShenyangChina
  3. 3.The James Buchanan Brady Urological Institute and Department of UrologyJohns Hopkins University School of MedicineBaltimoreUSA
  4. 4.Department of Oncology, Sidney Kimmel Comprehensive Cancer CenterJohns Hopkins University School of MedicineBaltimoreUSA

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