Evaluation of FDG uptake by renal malignancies (primary tumor or metastases) using a coincidence detection gamma camera.

Abstract

UNLABELLED:

The aim of this study was to evaluate the usefulness of FDG scanning using an ordinary gamma camera equipped with coincidence detection (CDET) for 2 renal cancer indications: characterization and staging of renal masses before nephrectomy and search for recurrence after nephrectomy.

METHODS:

Between September 1997 and June 1998, a whole-body scan and at least 1 tomoscintigram were obtained on 23 occasions in 22 patients (fasting for at least 6 h) using a Prism XP 2000 CDET gamma camera; scanning was begun 45 min after intravenous injection of 150-250 MBq FDG.

RESULTS:

Postoperative histologic evidence was obtained from 13 of 16 patients who underwent FDG using a CDET gamma camera before renal surgery; 4 renal masses did not accumulate FDG (3 true-negatives, 1 false-negative), whereas 9 renal tumors accumulated FDG (8 true-positives, 1 false-positive). In the other 3 patients, only 1 extrarenal site of FDG uptake was checked and confirmed on histologic examination: a bone metastasis from renal cell carcinoma in 2 cases and lymph node metastasis from a squamous cell carcinoma (3 true-positives). The primary local and regional staging of the malignant renal tumors was accurate in the 9 patients who underwent nephrectomy (8 true-negatives, 1 true-positive). The primary distant staging was positive in 1 case (focus in the chest corresponding to a probable true-positive on follow-up). In the 7 examinations performed because of suspected recurrence of renal cell carcinoma several months after nephrectomy, metastases were visualized by FDG in 4 patients, confirmed by biopsy in 2 patients, and confirmed by conventional imaging or follow-up (or both) in 2 patients. The other 3 patients had negative FDG scans, corresponding to probable true-negative results on follow-up.

CONCLUSION:

FDG using a CDET gamma camera can be used effectively for the staging and restaging of renal tumors and might be useful for characterization of the primary renal tumor in doubtful cases.

• Authors: F Montravers, D Grahek, K Kerrou, N Younsi, J D Doublet, B Gattegno, J Rossert, M A Costa de Beauregard, P Thibault, J N Talbot
• Journal: Journal of nuclear medicine : official publication, Society of Nuclear Medicine (J Nucl Med) Vol. 41 Issue 1 Pg. 78-84 (Jan 2000) ISSN: 0161-5505 [Print] United States
• PMID: 10647608 (Publication Type: Journal Article)

Chemical References

• Fluorine Radioisotopes
• Radiopharmaceuticals
• Fluorodeoxyglucose F18

Topics

• Carcinoma, Renal Cell (diagnostic imaging)
• Female
• Fluorine Radioisotopes
• Fluorodeoxyglucose F18
• Gamma Cameras
• Humans
• Kidney Neoplasms (diagnostic imaging, pathology, secondary)
• Male
• Middle Aged
• Neoplasm Recurrence, Local (diagnostic imaging)
• Neoplasm Staging
• Nephrectomy
• Radiopharmaceuticals
• Tomography, Emission-Computed