Top

Published in:

01-02-2019 | Original Article

Imaging of renal cell carcinoma in patients with acquired cystic disease of the kidney: comparison ¹¹C-choline and FDG PET/CT with dynamic contrast-enhanced CT

Authors: Kazuhiro Kitajima, Shingo Yamamoto, Yusuke Kawanaka, Takayuki Katsuura, Masahiro Fujita, Yukako Nakanishi, Yusuke Yamada, Takahiko Hashimoto, Toru Suzuki, Shuken Go, Akihiro Kanematsu, Michio Nojima, Koichiro Yamakado

Published in: Japanese Journal of Radiology | Issue 2/2019

Abstract

Purpose

To evaluate renal cell carcinoma (RCC) findings in acquired cystic disease of the kidney (ACDK) shown by ¹¹C-choline and FDG PET/CT, and contrast-enhanced CT.

Materials and methods

Six ACDK patients with 7 RCCs underwent ¹¹C-choline and FDG PET/CT, and contrast-enhanced CT before nephrectomy. Findings obtained with 3 imagings were evaluated and sensitivity detecting RCC was compared using 3-point grading scale (negative, equivocal, positive). The equivocal scale used for SUVmax ranged from 2.0 to 3.0 for PET/CT and a peak enhancement value ranging from 20 to 30 HU was used for CT.

Result

The histopathologic subtypes of 7 RCCs were clear-cell (n = 4) and ACD-associated RCC (n = 3). The negative/equivocal/positive grading results were 0/0/7 for ¹¹C-choline-PET/CT, 0/3/4 for FDG-PET/CT, and 2/2/3 for CT. Three equivocal cases by FDG-PET/CT were 2 clear-cell RCCs and 1 ACD-associated RCC. CT of 3 ACD-associated RCCs showed negativity for 2 and equivocality for 1. Sensitivity defining equivocal interpretation as negative for ¹¹C-choline-PET/CT, FDG-PET/CT, and CT was 100% (7/7), 57.1% (4/7), and 42.9% (3/7).

Conclusion

¹¹C-choline-PET/CT was more sensitive to detect RCC in ACDK as compared to FDG-PET/CT and contrast-enhanced CT in our series. FDG-PET/CT may be limited for detecting clear-cell RCC, while CT may have difficulty with detection of ACD-associated RCC.

Ishikawa I. Uremic acquired renal cystic disease. Natural history and complications. Nephron. 1991;58:257–67.CrossRefPubMed

Farivar-Mohseni H, Perlmutter AE, Wilson S, Shingleton WB, Bigler SA, Fowler JE Jr. Renal cell carcinoma and end stage renal disease. J Urol. 2006;175:2018–20 (discussion 2021).CrossRefPubMed

Tickoo SK, dePeralta-Venturina MN, Harik LR, Worcester HD, Salama ME, Young AN, et al. Spectrum of epithelial neoplasms in end-stage renal disease: an experience from 66 tumor-bearing kidneys with emphasis on histologic patterns distinct from those in sporadic adult renal neoplasia. Am J Surg Pathol. 2006;30:141–53.CrossRef

Foshat M, Eyzaguirre E. Acquired cystic disease-associated renal cell carcinoma: review of pathogenesis, morphology, ancillary tests, and clinical features. Arch Pathol Lab Med. 2017;141:600–6.CrossRef

Heinz-Peer G, Maier A, Eibenberger K, Grabenwöger F, Kreuzer S, Ba-Ssalamah A, et al. Role of magnetic resonance imaging in renal transplant recipients with acquired cystic kidney disease. Urology. 1998;51:534–8.CrossRefPubMed

Levine E. Renal cell carcinoma in uremic acquired renal cystic disease: incidence, detection, and management. Urol Radiol. 1992;13:203–10.CrossRefPubMed

Gulanikar AC, Daily PP, Kilambi NK, Hamrick-Turner JE, Butkus DE. Prospective pretransplant ultrasound screening in 206 patients for acquired renal cysts and renal cell carcinoma. Transplantation. 1998;66:1669–72.CrossRefPubMed

Cho C, Friedland GW, Swenson RS. Acquired renal cystic disease and renal neoplasms in hemodialysis patients. Urol Radiol. 1984;6:153–7.CrossRefPubMed

Takebayashi S, Hidai H, Chiba T, Takagi H, Koike S, Matsubara S. Using helical CT to evaluate renal cell carcinoma in patients undergoing hemodialysis: value of early enhanced images. AJR Am J Roentgenol. 1999;172:429–33.CrossRefPubMed

10.

Ferda J, Hora M, Hes O, Reischig T, Kreuzberg B, Mírka H, et al. Computed tomography of renal cell carcinoma in patients with terminal renal impairment. Eur J Radiol. 2007;63:295–301.CrossRefPubMed

11.

Rofsky NM, Weinreb JC, Bosniak MA, Libes RB, Birnbaum BA. Renal lesion characterization with gadolinium-enhanced MR imaging: efficacy and safety in patients with renal insufficiency. Radiology. 1991;180:85–9.CrossRefPubMed

12.

Akita H, Jinzaki M, Akita A, Mikami S, Oya M, Kuribayashi S. Renal cell carcinoma in patients with acquired cystic disease of the kidney: assessment using a combination of T2-weighted, diffusion-weighted, and chemical-shift MRI without the use of contrast material. J Magn Reson Imaging. 2014;39:924–30.CrossRefPubMed

13.

Ishikawa I, Morita K, Hayama S, Nakazawa T, Araki I, Higashi K, et al. Imaging of acquired cystic disease-associated renal cell carcinoma by contrast-enhanced ultrasonography with perflubutane microbubbles and positron emission tomography-computed tomography. Clin Exp Nephrol. 2011;15:136–40.CrossRefPubMed

14.

Nakanishi Y, Kitajima K, Yamada Y, Hashimoto T, Suzuki T, Go S, et al. Diagnostic performance of ¹¹C-choline PET/CT and FDG PET/CT for staging and restaging of renal cell cancer. Ann Nucl Med. 2018. https://doi.org/10.1007/s12149-018-1287-3 (Epub ahead of print).CrossRefPubMed

15.

Hara T, Yuasa M. Automated synthesis of [¹¹C]choline, a positron-emitting tracer for tumor imaging. Appl Radiat Isot. 1999;50:531–3.CrossRefPubMed

16.

Curry NS. Small renal masses (lesions smaller than 3 cm): imaging evaluation and management. AJR Am J Roentgenol. 1995;164:355–62.CrossRefPubMed

17.

Kuo PH, Kanal E, Abu-Alfa AK, Cowper SE. Gadolinium-based MR contrast agents and nephrogenic systemic fibrosis. Radiology. 2007;242:647–9.CrossRefPubMed

18.

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.CrossRefPubMedCentralPubMed

19.

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.CrossRefPubMed

20.

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.PubMedCentralPubMed

Title: Imaging of renal cell carcinoma in patients with acquired cystic disease of the kidney: comparison 11C-choline and FDG PET/CT with dynamic contrast-enhanced CT
Authors: Kazuhiro Kitajima
Shingo Yamamoto
Yusuke Kawanaka
Takayuki Katsuura
Masahiro Fujita
Yukako Nakanishi
Yusuke Yamada
Takahiko Hashimoto
Toru Suzuki
Shuken Go
Akihiro Kanematsu
Michio Nojima
Koichiro Yamakado
Publication date: 01-02-2019
Publisher: Springer Japan
Published in: Japanese Journal of Radiology / Issue 2/2019
Print ISSN: 1867-1071
Electronic ISSN: 1867-108X
DOI: https://doi.org/10.1007/s11604-018-0789-1

At a glance: The STEP trials

Springer Medicine

Imaging of renal cell carcinoma in patients with acquired cystic disease of the kidney: comparison ¹¹C-choline and FDG PET/CT with dynamic contrast-enhanced CT

Abstract

Purpose

Materials and methods

Result

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Materials and methods

Result

Conclusion

Please log in to get access to this content

Other articles of this Issue 2/2019

Can low b value diffusion weighted imaging evaluate the character of cerebrospinal fluid dynamics?

CT-based mediastinal compartment classifications and differential diagnosis of mediastinal tumors

Recent technical development of artificial intelligence for diagnostic medical imaging

Potential value of the PixelShine deep learning algorithm for increasing quality of 70 kVp+ASiR-V reconstruction pelvic arterial phase CT images

Perfusion contrast-enhanced ultrasound to predict early lymph-node metastasis in breast cancer

The safety and efficacy of percutaneous vertebroplasty for patients over 90 years old