68Ga-dotatoc vs. 18F-FDG vs. radiolabelled PSMA PET/CT in renal cancer patients

[68Ga]-DOTATOC PET/CT and Clear Cell Renal Cell Carcinoma Metastasis: Simple False Positive or Potential Staging Imaging?

Clear cell renal cell carcinoma is the most common type of kidney cancer. Apart of lymph nodes, the frequent metastatic sites are lung, bone and, more rarely, pancreas. These three sites of involvement are also common for NETs. This well-differentiated tumour has a low FDG avidity. We report two clinical cases of pancreatic and pulmonary lesions, suspicious of NET but with a history of clear cell renal cell carcinoma. [68Ga]-DOTATOC PET/CT find strong uptakes but biopsies ultimately revealed metastases of clear cell renal cell carcinoma.

The role of [68 Ga]Ga-FAPI-04 PET/CT in renal cell carcinoma: a preliminary study

PURPOSE

We aimed to investigate the role of [68 Ga]Ga-FAPI-04 PET/CT and uptake patterns of primary and metastatic lesions in patients with renal cell carcinoma (RCC).

METHODS

Twenty patients with a suspicious lesion considered primary renal malignancy or a history of RCC were included in our study. Two patients were excluded from further analyses due to other confirmed malignancies. Six patients were newly diagnosed, while the indication of 12 patients was restaging. All patients underwent [68 Ga]Ga-FAPI-04 and [18F]F-FDG PET/CT. SUVmax and tumor-to-background ratio (TBR) of primary (n = 7) and local recurrent lesions (n = 6) and lymph node (n = 26), lung (n = 32), bone (n = 5), and other metastases (n = 14) were compared between the two tracers.

RESULTS

We detected 90 lesions in 18 patients with varying FAPI and FDG uptake values on both PET/CT. The median TBR of FAPI-PET/CT of all lesions was higher than TBR of FDG-PET/CT with statistically significance (5.6 vs. 2.1, p < 0.001). In primary and recurrent lesions, the median SUVmax, TBR, and tumor volume on FAPI-PET/CT were higher than FDG-PET/CT. The median SUVmax of lung lesions on FAPI-PET/CT was statistical significantly higher than FDG-SUVmax (3.8 vs. 1.8, p = 0.02). The median of FAPI-SUVmax on primary lesions was lower in the early stage based on TNM compared to the advanced stage. FAPI-SUVmax in 49% of all lesions were SUVmax ≥ 6, and 13% were SUVmax ≥ 10. In patient-based analyses, seven patients (39%) had at least one lesion with FAPI-SUVmax ≥ 10; 12 patients (67%) had at least one lesion with FAPI-SUVmax ≥ 6.

CONCLUSION

This study showed the potential utility of [68 Ga]Ga-FAPI-04 PET/CT showing promising results in RCC. We have presumed that FAPI-PET/CT may be performed for complementary imaging modality providing prognosis and possibility of theranostic application in selected patients.

Recent advances in imaging techniques of renal masses

Multiphasic multidetector computed tomography (CT) forms the mainstay for the characterization of renal masses whereas magnetic resonance imaging (MRI) acts as a problem-solving tool in some cases. However, a few of the renal masses remain indeterminate even after evaluation by conventional imaging methods. To overcome the deficiency in current imaging techniques, advanced imaging methods have been devised and are being tested. This review will cover the role of contrast-enhanced ultrasonography, shear wave elastography, dual-energy CT, perfusion CT, MR perfusion, diffusion-weighted MRI, blood oxygen level-dependent MRI, MR spectroscopy, positron emission tomography (PET)/prostate-specific membrane antigen-PET in the characterization of renal masses.

MicroRNA-384 inhibits nasopharyngeal carcinoma growth and metastasis via binding to Smad5 and suppressing the Wnt/β-catenin axis

Nasopharyngeal carcinoma (NPC) is a major otorhinolaryngological disease with limited effective therapeutic options. This work focused on the function of microRNA-384 (miR-384) on the NPC pathogenesis and the molecules involved. miR-384 expression in cancer tissues and cells was detected. Gain- and loss-of-functions of miR-384 were performed to identify its role in NPC progression. The target mRNA of miR-384 was predicted on an online system and validated through a luciferase reporter assay. The activity of Wnt/β-catenin signaling was detected. Consequently, miR-384 was found to be poorly expressed in NPC tissues and cell lines and was linked to unfavorable survival rates in patients. Overexpression of miR-384 in 6-10B cells suppressed growth, migration, invasion and resistance to apoptosis of cells, but inverse trends were presented in C6661 cells where miR-384 was downregulated. miR-384 targeted Smad5 mRNA. Upregulation of Smad5 counteracted the roles of miR-384 mimic in cells. The NPC-inhibiting effects of miR-384 mimic were also blocked by Wnt/β-catenin activation. To conclude, miR-384 targets Smad5 and inactivates the Wnt/β-catenin pathway, which exerts a suppressing role in NPC cell behaviors as well as tumor growth in vivo. The findings may offer novel thoughts into NPC therapy.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10616-021-00458-3.