Advertisement

Annals of Nuclear Medicine

, Volume 32, Issue 10, pp 658–668 | Cite as

Diagnostic performance of 11C-choline PET/CT and FDG PET/CT for staging and restaging of renal cell cancer

  • Yukako Nakanishi
  • Kazuhiro Kitajima
  • Yusuke Yamada
  • Takahiko Hashimoto
  • Toru Suzuki
  • Shuken Go
  • Akihiro Kanematsu
  • Michio Nojima
  • Koichiro Yamakado
  • Shingo Yamamoto
Original Article

Abstract

Purpose

To compare findings obtained with 11C-choline and FDG PET/CT scanning for renal cell carcinoma staging and restaging.

Materials and methods

Twenty-eight renal cell carcinoma patients whose histological subtype was clear cell type in 26 and papillary type in 2, while Fuhrman nuclear grade was G1,2 in 16 and G3,4 in 12, underwent both 11C-choline and FDG PET/CT examinations before (n = 10) and/or after (n = 18) treatment, then those scanning modalities were compared in regard to patient- and lesion-based diagnostic performance using 5 grading scores. Final diagnosis in each case was obtained based on histopathology, conventional radiological imaging, and clinical follow-up findings. The differences between 11C-choline and FDG PET/CT findings were evaluated using receiver-operating-characteristic (ROC) analysis and a McNemar test.

Results

Patient-based sensitivity, specificity, positive predictive, negative predictive, accuracy, and area under the ROC curve (AUC) values for 11C-choline PET/CT for staging and restaging were 88.0% (22/25), 66.7% (2/3), 95.7% (22/23), 40.0% (2/5), 85.7% (24/28), and 0.887, respectively, while those for FDG-PET/CT were 56.0% (14/25), 66.7% (2/3), 93.3% (14/15), 15.4% (2/13), 57.1% (16/28), and 0.647, respectively. Sensitivity, accuracy, and AUC were significantly different (p = 0.013, p = 0.013, p = 0.012, respectively). Among the 120 lesions, those with kidney, lung, lymph node, bone, pancreas, venous tumor thrombosis, adrenal gland, liver, or skin localization numbered 15, 64, 16, 13, 4, 3, 2, 2, and 1, respectively. For all 120 lesions, 75 (62.5%) and 47 (39.2%) were detected by 11C-choline and FDG PET/CT, respectively (p < 0.0001).

Conclusion

For staging and restaging of renal cell carcinoma patients, 11C-choline-PET/CT is significantly more useful than FDG-PET/CT.

Keywords

Renal cell carcinoma PET Choline FDG 

Notes

Compliance with ethical standards

Conflict of interest

We declare no financial support or relationship that may pose conflict of interest.

Ethical approval

We clearly state that human participants have the approval of an appropriate named ethics committee including Helsinki declaration. We declare no financial support or relationship that may pose conflict of interest. The authors confirm that this manuscript has not been published or presented elsewhere, in part or in entirety, and is not under consideration by any other journal. All authors have made substantial contributions to this work and have read and approved the final submitted version.

References

  1. 1.
    Ljungberg B, Bensalah K, Canfield S, Dabestani S, Hofmann F, Hora M, et al. Guidelines on renal cell carcinoma. Eur Urol. 2015;67:913–24.CrossRefGoogle Scholar
  2. 2.
    Escudier B, Porta C, Schmidinger M, Algaba F, Patard JJ, Khoo V, et al. ESMO Guidelines Working Group. Renal cell carcinoma: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2014;25(Suppl 3):49–56.CrossRefGoogle Scholar
  3. 3.
    Smaldone MC, Chen DY, Yu JQ, Plimack ER. Potential role of (124)I-girentuximab in the presurgical diagnosis of clear-cell renal cell cancer. Biologics. 2012;6:395–407.PubMedPubMedCentralGoogle Scholar
  4. 4.
    Horn KP, Yap JT, Agarwal N, Morton KA, Kadrmas DJ, Beardmore B, et al. FDG and FLT-PET for early measurement of response to 37.5 mg daily sunitinib therapy in metastatic renal cell carcinoma. Cancer Imaging. 2015;15:15.CrossRefGoogle Scholar
  5. 5.
    Oyama N, Takahara N, Hasegawa Y, Tanase K, Miwa Y, Akino H, et al. Assessment of therapeutic effect of sunitinib by 11C-Acetate PET compared with FDG PET imaging in a patient with metastatic renal cell carcinoma. Nucl Med Mol Imaging. 2011;45:217–19.CrossRefGoogle Scholar
  6. 6.
    Middendorp M, Maute L, Sauter B, Vogl TJ, Grünwald F. Initial experience with 18F-fluoroethylcholine PET/CT in staging and monitoring therapy response of advanced renal cell carcinoma. Ann Nucl Med. 2010;24:441–6.CrossRefGoogle Scholar
  7. 7.
    Kitajima K, Fukushima K, Yamamoto S, Kato T, Odawara S, Takaki H, et al. 11C-Choline positive but 18F-FDG negative pancreatic metastasis from renal cell carcinoma on PET. Nagoya J Med Sci. 2017;79:273–7.PubMedPubMedCentralGoogle Scholar
  8. 8.
    Hugonnet F, Fournier L, Medioni J, Smadja C, Hindié E, Huchet V, et al. Hypoxia in Renal Cancer Multicenter Group: metastatic renal cell carcinoma: relationship between initial metastasis hypoxia, change after 1 month’s sunitinib, and therapeutic response: an 18F-fluoromisonidazole PET/CT study. J Nucl Med. 2011;52:1048–55.CrossRefGoogle Scholar
  9. 9.
    Schuster DM, Nye JA, Nieh PT, Votaw JR, Halkar RK, Issa MM, et al. Initial experience with the radiotracer anti-1amino-3-[18F]fluorocyclobutane-1-carboxylic acid (anti-[18F] FACBC) with PET in renal carcinoma. Mol Imaging Biol. 2009;11:434–8.CrossRefGoogle Scholar
  10. 10.
    Siva S, Callahan J, Pryor D, Martin J, Lawrentschuk N, Hofman MS. Utility of 68Ga prostate specific membrane antigen - positron emission tomography in diagnosis and response assessment of recurrent renal cell carcinoma. J Med Imaging Radiat Oncol. 2017;61:372–8.CrossRefGoogle Scholar
  11. 11.
    Uchida T, Yamashita S. Molecular cloning, characterization, and expression in Escherichia coli of a cDNA encoding mammalian choline kinase. J Biol Chem. 1992;267:10156–62.PubMedGoogle Scholar
  12. 12.
    Kitajima K, Yamamoto S, Fukushima K, Minamimoto R, Kamai T, Jadvar H. Update on advances in molecular PET in urological oncology. Jpn J Radiol. 2016;34:470–85.CrossRefGoogle Scholar
  13. 13.
    Hara T, Yuasa M. Automated synthesis of [11C]choline, a positron-emitting tracer for tumor imaging. Appl Radiat Isot. 1999;50:531–3.CrossRefGoogle Scholar
  14. 14.
    Nakatani K, Nakamoto Y, Saga T, Higashi T, Togashi K. The potential clinical value of FDG-PET for recurrent renal cell carcinoma. Eur J Radiol. 2011;79:29–35.CrossRefGoogle Scholar
  15. 15.
    Alongi P, Picchio M, Zattoni F, Spallino M, Gianolli L, Saladini G, et al. Recurrent renal cell carcinoma: clinical and prognostic value of FDG PET/CT. Eur J Nucl Med Mol Imaging. 2016;43:464–73.CrossRefGoogle Scholar
  16. 16.
    Kang DE, White RL Jr, Zuger JH, Sasser HC, Teigland CM. Clinical use of fluorodeoxyglucose F 18 positron emission tomography for detection of renal cell carcinoma. J Urol. 2004;171:1806–9.CrossRefGoogle Scholar
  17. 17.
    Kumar R, Shandal V, Shamim SA, Jeph S, Singh H, Malhotra A. Role of FDG PET-CT in recurrent renal cell carcinoma. Nucl Med Commun. 2010;31:844–50.PubMedGoogle Scholar
  18. 18.
    Fuccio C, Ceci F, Castellucci P, Spinapolice EG, Palumbo R, D’Ambrosio D, et al. Restaging clear cell renal carcinoma with 18F-FDG PET/CT. Clin Nucl Med. 2014;39:e320-4.PubMedGoogle Scholar
  19. 19.
    Ma H, Shen G, Liu B, Yang Y, Ren P, Kuang A. Diagnostic performance of 18F-FDG PET or PET/CT in restaging renal cell carcinoma: a systematic review and meta-analysis. Nucl Med Commun. 2017;38:156–63.CrossRefGoogle Scholar
  20. 20.
    Wang HY, Ding HJ, Chen JH, Chao CH, Lu YY, Lin WY, et al. Meta-analysis of the diagnostic performance of [18F]FDGPET and PET/CT in renal cell carcinoma. Cancer Imaging. 2012;12:464–74.CrossRefGoogle Scholar
  21. 21.
    Miyakita H, Tokunaga M, Onda H, Usui Y, Kinoshita H, Kawamura N, et al. Significance of 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) for detection of renal cell carcinoma and immunohistochemical glucose transporter 1 (GLUT-1) expression in the cancer. Int J Urol. 2002;9:15–8.CrossRefGoogle Scholar
  22. 22.
    Aide N, Cappele O, Bottet P, Bensadoun H, Regeasse A, Comoz F, et al. Efficiency of [18F]FDG PET in characterising renal cancer and detecting distant metastases: a comparison with CT. Eur J Nucl Med Mol Imaging. 2003;30:1236–45.CrossRefGoogle Scholar
  23. 23.
    Majhail NS, Urbain JL, Albani JM, Kanvinde MH, Rice TW, Novick AC, et al. F-18 fluorodeoxyglucose positron emission tomography in the evaluation of distant metastases from renal cell carcinoma. J Clin Oncol. 2003;21:3995–4000.CrossRefGoogle Scholar
  24. 24.
    Nakajima R, Nozaki S, Kondo T, Nagashima Y, Abe K, Sakai S. Evaluation of renal cell carcinoma histological subtype and Fuhrman grade using 18F-fluorodeoxyglucose-positron emission tomography/computed tomography. Eur Radiol. 2017;27:4866–73.CrossRefGoogle Scholar
  25. 25.
    Visentin M, Torozi A, Gai Z, Häusler S, Li C, Hiller C, et al. Fluorocholine transport mediated by the organic cation transporter 2 (OCT2, SLC22A2): implication for imaging of kidney tumors. Drug Metab Dispos. 2018;46:1129–36.CrossRefGoogle Scholar

Copyright information

© The Japanese Society of Nuclear Medicine 2018

Authors and Affiliations

  • Yukako Nakanishi
    • 1
  • Kazuhiro Kitajima
    • 2
  • Yusuke Yamada
    • 1
  • Takahiko Hashimoto
    • 1
  • Toru Suzuki
    • 1
  • Shuken Go
    • 1
  • Akihiro Kanematsu
    • 1
  • Michio Nojima
    • 1
  • Koichiro Yamakado
    • 3
  • Shingo Yamamoto
    • 1
  1. 1.Department of UrologyHyogo College of MedicineNishinomiyaJapan
  2. 2.Department of Radiology, Division of Nuclear Medicine and PET CenterHyogo College of MedicineNishinomiyaJapan
  3. 3.Department of RadiologyHyogo College of MedicineNishinomiyaJapan

Personalised recommendations