Dual-Tracer PET/CT in Renal Angiomyolipoma and Subtypes of Renal Cell Carcinoma

被引:41
作者
Ho, Chi-lai [1 ,2 ]
Chen, Sirong [1 ,2 ,3 ]
Ho, Kossen Man Tzit [4 ]
Chan, Wai Kong [5 ]
Leung, Yim Lung [1 ,2 ]
Cheng, Kam Chau [1 ,2 ]
Wong, Ka-nin [1 ,2 ]
Cheung, Man-ki [1 ,2 ]
Wong, Kwok Kee [4 ]
机构
[1] Hong Kong Sanat & Hosp, Dept Nucl Med, Happy Valley, Hong Kong, Peoples R China
[2] Hong Kong Sanat & Hosp, PET, Happy Valley, Hong Kong, Peoples R China
[3] Hong Kong Sanat & Hosp, Med Phys & Res Dept, Happy Valley, Hong Kong, Peoples R China
[4] Hong Kong Sanat & Hosp, Hong Kong Urol Clin, Happy Valley, Hong Kong, Peoples R China
[5] Hong Kong Sanat & Hosp, Dept Pathol, Happy Valley, Hong Kong, Peoples R China
关键词
C-11-Acetate; F-18-FDG; angiomyolipoma; RCC; PET/CT; POSITRON-EMISSION-TOMOGRAPHY; NEPHRON-SPARING SURGERY; MIMICKING ANGIOMYOLIPOMA; HEPATOCELLULAR-CARCINOMA; FAT; TUMOR; CT; MANAGEMENT; DIAGNOSIS; KIDNEY;
D O I
10.1097/RLU.0b013e318266cde2
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
We studied the metabolic characteristics of RCC subtypes and angiomyolipoma with F-18-FDG and C-11-acetate PET/CT. Methods: Fifty-eight patients with both baseline CT and dual-tracer PET/CT were recruited: 10 angiomyolipoma (16 lesions) and 48 RCC (50 lesions). Each lesion was assessed for SUVmax ratio (lesion-to-normal kidney) on C-11-acetate/F-18-FDG PET and attenuation density on CT. Receiver operating characteristic (ROC) curve was analyzed to define the threshold of C-11-acetate SUVmax ratio for differentiating angiomyolipoma from RCC. Thirty-nine RCC patients were selected for 3-year disease-free survival analysis. Results: All angiomyolipoma showed negative F-18-FDG but markedly increased C-11-acetate metabolism, significantly higher than RCC (C-11-acetate SUVmax ratio = 4.11 +/- 0.53 vs 2.00 +/- 0.71; P < 0.05). C-11-acetate SUVmax ratio = 3.71 could differentiate angiomyolipoma including "fat- poor angiomyolipoma" (n = 10) from RCC with sensitivity of 93.8% (15/16) and specificity of 98.0% (49/50). Different RCC subtypes/grades (25 low- and 11 high-grade clear cell [CC], 7 chromophobe, 4 papillary, and 1 collecting duct) were found to have different dual-tracer metabolic pattern (P < 0.05), with overall RCC detection sensitivity of 90%(45/50). All chromophobe RCC were avid only for C-11-acetate but not F-18-FDG, whereas papillary RCC were primarily the opposite. RCC-CC showed variable dual-tracer uptake: high-grade more avid for F-18-FDG, low-grade more for C-11-acetate. Four RCC cases negative by dual-tracers were of low- grade RCC-CC. "Primary RCC being F-18-FDG-avid" was the only independent predictor of RCC recurrence in 3 years (P G 0.05), with a median disease-free survival of 22 months. Conclusion: C-11-acetate PET/CT helps in differentiating "fat-poor angiomyolipoma" from RCC. Dual-tracer PET/CT has value in diagnosis of RCC subtypes and predicting survival.
引用
收藏
页码:1075 / 1082
页数:8
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