1
|
Ouvrard E, Kaseb A, Poterszman N, Porot C, Somme F, Imperiale A. Nuclear medicine imaging for bone metastases assessment: what else besides bone scintigraphy in the era of personalized medicine? Front Med (Lausanne) 2024; 10:1320574. [PMID: 38288299 PMCID: PMC10823373 DOI: 10.3389/fmed.2023.1320574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 12/28/2023] [Indexed: 01/31/2024] Open
Abstract
Accurate detection and reliable assessment of therapeutic responses in bone metastases are imperative for guiding treatment decisions, preserving quality of life, and ultimately enhancing overall survival. Nuclear imaging has historically played a pivotal role in this realm, offering a diverse range of radiotracers and imaging modalities. While the conventional bone scan using 99mTc marked bisphosphonates has remained widely utilized, its diagnostic performance is hindered by certain limitations. Positron emission tomography, particularly when coupled with computed tomography, provides improved spatial resolution and diagnostic performance with various pathology-specific radiotracers. This review aims to evaluate the performance of different nuclear imaging modalities in clinical practice for detecting and monitoring the therapeutic responses in bone metastases of diverse origins, addressing their limitations and implications for image interpretation.
Collapse
Affiliation(s)
- Eric Ouvrard
- Nuclear Medicine and Molecular Imaging, Institut de Cancérologie Strasbourg Europe (ICANS), University Hospitals of Strasbourg, University of Strasbourg, Strasbourg, France
| | - Ashjan Kaseb
- Nuclear Medicine and Molecular Imaging, Institut de Cancérologie Strasbourg Europe (ICANS), University Hospitals of Strasbourg, University of Strasbourg, Strasbourg, France
- Radiology, College of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - Nathan Poterszman
- Nuclear Medicine and Molecular Imaging, Institut de Cancérologie Strasbourg Europe (ICANS), University Hospitals of Strasbourg, University of Strasbourg, Strasbourg, France
| | - Clémence Porot
- Radiopharmacy, Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg, France
| | - Francois Somme
- Nuclear Medicine and Molecular Imaging, Institut de Cancérologie Strasbourg Europe (ICANS), University Hospitals of Strasbourg, University of Strasbourg, Strasbourg, France
| | - Alessio Imperiale
- Nuclear Medicine and Molecular Imaging, Institut de Cancérologie Strasbourg Europe (ICANS), University Hospitals of Strasbourg, University of Strasbourg, Strasbourg, France
- IPHC, UMR 7178, CNRS/Unistra, Strasbourg, France
| |
Collapse
|
2
|
Jena R, Narain TA, Singh UP, Srivastava A. Role of positron emission tomography/computed tomography in the evaluation of renal cell carcinoma. Indian J Urol 2021; 37:125-132. [PMID: 34103794 PMCID: PMC8173953 DOI: 10.4103/iju.iju_268_20] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 08/12/2020] [Accepted: 10/04/2020] [Indexed: 01/03/2023] Open
Abstract
Introduction: Positron emission tomography (PET) is not a standard recommendation in most of the major guidelines for the evaluation of renal cell carcinoma (RCC). Earlier studies evaluating PET scan in patients with RCC have provided discordant results. However, with the advent of newer hybrid PET/computed tomography (CT) scanning systems, this modality has shown increased efficacy in the evaluation of primary renal masses along with the detection of extrarenal metastases, restaging recurrent RCC, and also in monitoring response to targeted therapy. We performed a systematic review of the existing literature on the role of PET scan in the evaluation of RCC. Methodology: We systematically searched the databases of PubMed/Medline, Embase, and Google Scholar to identify studies on the use of PET scan in RCC. Using Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines, 94 full-text articles were selected, of which 54 relevant articles were then reviewed, after a consensus by the authors. Results: Several studies have shown similar sensitivity and specificity of fluoro-2-deoxy-2-d-glucose-PET (FDG-PET) scan as compared to conventional CT scan for the initial diagnosis of RCC, and an improved sensitivity and specificity for the detection of metastases and recurrences following curative therapy. The PET scan may also play a role in predicting the initial tumor biology and pathology and predicting the prognosis as well as the response to therapy. Conclusion: The current guidelines do not recommend PET scan in the staging armamentarium of RCCs. However, FDG-PET scan is as efficacious, if not better than conventional imaging alone, in the evaluation of the primary and metastatic RCC, as well as in evaluating the response to therapy, due to its ability to pick up areas of increased metabolic activity early on. Newer tracers such as Ga68 prostate specific membrane antigen-labeled ligands may help in opening up newer avenues of theragnostics.
Collapse
Affiliation(s)
- Rahul Jena
- Department of Urology and Renal Transplant, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Tushar Aditya Narain
- Department of Urology, All India Institute of Medical Sciences, Rishikesh, Uttarkhand, India
| | - Uday Pratap Singh
- Department of Urology and Renal Transplant, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Aneesh Srivastava
- Department of Urology and Renal Transplant, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| |
Collapse
|
3
|
Dibble EH, Kravets S, Cheng S, Sakellis C, Gray KP, Abbott A, Bossé D, Pomerantz MM, McGregor BA, Harshman LC, Michaelson MD, McKay RR, Choueiri TK, Krajewski KM, Jacene HA. Utility of FDG-PET/CT in Patients with Advanced Renal Cell Carcinoma with Osseous Metastases: Comparison with CT and 99mTc-MDP Bone Scan in a Prospective Clinical Trial. KCA 2019. [DOI: 10.3233/kca-190075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Elizabeth H. Dibble
- Department of Diagnostic Imaging, The Warren Alpert Medical School of Brown University/Rhode Island Hospital, Providence, RI, USA
| | - Sasha Kravets
- Department of Data Sciences, Division of Biostatistics, Dana-Farber Cancer Institute, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - SuChun Cheng
- Department of Data Sciences, Division of Biostatistics, Dana-Farber Cancer Institute, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Christopher Sakellis
- Department of Imaging, Dana-Farber Cancer Institute, and Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Kathryn P. Gray
- Department of Data Sciences, Division of Biostatistics, Dana-Farber Cancer Institute, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Amanda Abbott
- Department of Imaging, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Dominick Bossé
- The Ottawa Hospital Cancer Center, Ottawa, ON, Canada
- Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Mark M. Pomerantz
- Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Bradley A. McGregor
- Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Lauren C. Harshman
- Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - M. Dror Michaelson
- Genitourinary Cancer Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Rana R. McKay
- Department of Medicine, Division of Hematology/Oncology, University of California, San Diego, CA, USA
| | - Toni K. Choueiri
- Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Katherine M. Krajewski
- Department of Imaging, Dana-Farber Cancer Institute, and Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Heather A. Jacene
- Department of Imaging, Dana-Farber Cancer Institute, and Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
4
|
Karivedu V, Jain AL, Eluvathingal TJ, Sidana A. Role of Positron Emission Tomography Imaging in Metabolically Active Renal Cell Carcinoma. Curr Urol Rep 2019; 20:56. [PMID: 31468240 DOI: 10.1007/s11934-019-0932-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE OF REVIEW The clinical role of fluorine-18 fluoro-2-deoxyglucose (FDG)-positron emission tomography (PET) in renal cell carcinoma (RCC) is still evolving. Use of FDG PET in RCC is currently not a standard investigation in the diagnosis and staging of RCC due to its renal excretion. This review focuses on the clinical role and current status of FDG PET and PET/CT in RCC. RECENT FINDINGS Studies investigating the role of FDG PET in localized RCC were largely disappointing. Several studies have demonstrated that the use of hybrid imaging PET/CT is feasible in evaluating the extra-renal disease. A current review of the literature determines PET/CT to be a valuable tool both in treatment decision-making and monitoring and in predicting the survival in recurrent and metastatic RCC. PET/CT might be a viable option in the evaluation of RCC, especially recurrent and metastatic disease. PET/CT has also shown to play a role in predicting survival and monitoring therapy response.
Collapse
|
5
|
Matsuda S, Yoshimura H, Yoshida H, Taga M, Imamura Y, Kiyoshima T, Sano K. Ossifying fibroma in the mandibular angle mimicking metastatic clear cell renal cell carcinoma: A case report. Medicine (Baltimore) 2019; 98:e16595. [PMID: 31415350 PMCID: PMC6831422 DOI: 10.1097/md.0000000000016595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Ossifying fibroma is benign fibro-osseous neoplasm. The authors report a case of ossifying fibroma in the mandibular angle suspected as metastasis of clear cell renal cell carcinoma. PATIENT CONCERNS A 74-year-old man presented to the primary hospital complaining of frequent urination. A tumor in the left kidney was detected via an abdominal computed tomography scan. The patient then visited the Department of Urology at our hospital. DIAGNOSES According to whole-body imaging examinations, the patient was suspected of having renal cancer with mandibular metastasis. Also, a cystic lesion of the maxilla was revealed. INTERVENTIONS Left nephrectomy was performed by urologists, and the patient was diagnosed with clear cell renal cell carcinoma of the left kidney. Approximately 1 month later, resection with a safety margin of the mandibular lesion and removal of the maxillary lesion were performed by oral and maxillofacial surgeons. OUTCOMES The patient was diagnosed with ossifying fibroma of the mandible and an odontogenic keratocyst of the maxilla via a histopathological examination. Eighteen months have passed since the operation without clinical and imaging findings associated with recurrence. LESSONS Ossifying fibroma in the mandibular angle of elderly patients is extremely rare. Surgeons should consider the possibility of metastasis when osteolytic lesions of the jaw are found in patients with cancer.
Collapse
Affiliation(s)
- Shinpei Matsuda
- Department of Dentistry and Oral Surgery, Unit of Sensory and Locomotor Medicine, Division of Medicine
| | - Hitoshi Yoshimura
- Department of Dentistry and Oral Surgery, Unit of Sensory and Locomotor Medicine, Division of Medicine
| | - Hisato Yoshida
- Department of Dentistry and Oral Surgery, Unit of Sensory and Locomotor Medicine, Division of Medicine
| | - Minekatsu Taga
- Department of Urology, Faculty of Medical Sciences, University of Fukui
| | - Yoshiaki Imamura
- Division of Surgical Pathology, University of Fukui Hospital, Fukui
| | - Tamotsu Kiyoshima
- Laboratory of Oral Pathology, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Kazuo Sano
- Department of Dentistry and Oral Surgery, Unit of Sensory and Locomotor Medicine, Division of Medicine
| |
Collapse
|
6
|
Özdemir Y, Torun N, Topkan E. Stereotaktik radyocerrahi uygulanan vertebra metastazlarında yanıt değerlendirmesinde PET-BT’nin yeri. Cukurova Medical Journal 2019. [DOI: 10.17826/cumj.453287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
7
|
|
8
|
Abstract
PURPOSE Imaging plays a key role throughout the renal cell carcinoma (RCC) patient pathway, from diagnosis and staging of the disease, to the assessment of response to therapy. This review aims to summarise current knowledge with regard to imaging in the RCC patient pathway, highlighting recent advances and challenges. METHODS A literature review was performed using Medline. Particular focus was paid to RCC imaging in the diagnosis, staging and response assessment following therapy. RESULTS Characterisation of small renal masses (SRM) remains a diagnostic conundrum. Contrast-enhanced ultrasound (CEUS) has been increasingly applied in this field, as have emerging technologies such as multiparametric MRI, radiomics and molecular imaging with 99mtechnetium-sestamibi single photon emission computed tomography/CT. CT remains the first-line modality for staging of locoregional and suspected metastatic disease. Although the staging accuracy of CT is good, limitations in determining nodal status persist. Response assessment following ablative therapies remains challenging, as reduction in tumour size may not occur. The pattern of enhancement on CT may be a more reliable indicator of treatment success. CEUS may also have a role in monitoring response following ablation. Response assessments following anti-angiogenic and immunotherapies in advanced RCC is an evolving field, with a number of alternative response criteria being proposed. Tumour response patterns may vary between different immunotherapy agents and tumour types; thus, future response criteria modifications may be inevitable. CONCLUSION The diagnosis and characterisation of SRM and response assessment following targeted therapy for advanced RCC are key challenges which warrant further research.
Collapse
Affiliation(s)
- Sabrina H Rossi
- Academic Urology Group, University of Cambridge, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Davide Prezzi
- Cancer Imaging, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
- Department of Radiology, Guy's & St Thomas' NHS Foundation Trust, London, SE1 7EH, UK
| | - Christian Kelly-Morland
- Cancer Imaging, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
- Department of Radiology, Guy's & St Thomas' NHS Foundation Trust, London, SE1 7EH, UK
| | - Vicky Goh
- Cancer Imaging, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK.
- Department of Radiology, Guy's & St Thomas' NHS Foundation Trust, London, SE1 7EH, UK.
| |
Collapse
|
9
|
Gündoğan C, Çermik TF, Erkan E, Yardimci AH, Behzatoğlu K, Tatar G, Okçu O, Toktaş MG. Role of contrast-enhanced 18F-FDG PET/CT imaging in the diagnosis and staging of renal tumors. Nucl Med Commun 2018; 39:1174-82. [PMID: 30234688 DOI: 10.1097/MNM.0000000000000915] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE The objectives of this prospective study are to compare intravenous contrast-enhanced (CE) fluorine-18-fluorodeoxyglucose (F-FDG) PET/computed tomography (CE F-FDG PET/CT) with conventional methods (CT/MRI) and to evaluate the relationship of maximum standardized uptake value (SUVmax) with Fuhrman grade in patients with renal tumors. PATIENTS AND METHODS A total of 62 patients [35 males and 27 females; mean age 55.8±12.7 (range: 27-81) years] were enrolled in the study. CE F-FDG PET/CT scanning included whole-body (early) and abdominal imaging (late) 1 and 2 h after intravenous F-FDG administration, respectively. SUVmax was calculated for primary tumors. CE F-FDG PET/CT and CT/MRI findings were compared with respect to primary tumors and staging. RESULTS The sensitivity of CE F-FDG PET/CT in primary tumor detection was 98%, which was very close to that of CT/MRI (100%). CE F-FDG PET/CT resulted in correct staging in 84% of the cases, compared with 68% of the cases with conventional methods (52 vs. 42 patients). SUVmax values of early PET for the primary tumors were significantly correlated with the Fuhrman grades (P<0.001). CE F-FDG PET/CT enabled the detection of synchronous tumors in four patients, one of which was incorrectly diagnosed as having metastasis by CT. Distant metastases were detected in 16 patients with CE F-FDG PET/CT and in 13 patients with routine conventional methods. CONCLUSION CE F-FDG PET/CT showed similar results compared with CT/MRI in the detection of primary tumors, but it was superior to conventional methods in the detection of metastasis and staging. Given the highly significant correlation between SUVmax values and the Fuhrman grading, CE F-FDG PET/CT may play a significant role in the evaluation of patient prognosis.
Collapse
|
10
|
Zaman MU, Fatima N, Zaman A, Zaman U, Tahseen R, Zaman S. Massive Tumor Thrombus in Left Renal Vein and Inferior Vena Cava in Renal Cell Carcinoma on 18-fluorodeoxyglucose Positron Emission Tomography/computerized Tomography: "Suspension Bridge Sign". World J Nucl Med 2018; 17:120-122. [PMID: 29719488 PMCID: PMC5905257 DOI: 10.4103/wjnm.wjnm_30_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Tumor thrombosis is a relatively uncommon complication of renal cell carcinoma (RCC), and its diagnosis has therapeutic and prognostic implication. Computerized tomography (CT) is the primary imaging modality for staging RCC, but it has low sensitivity to differentiate between tumor thrombus and bland or benign thrombus. 18-fluorodeoxyglucose positron emission tomography/CT (PET/CT) has a limited role in diagnosis and staging of RCC, but its diagnostic accuracy is considerably high for detection of metabolically active tumor thrombus. We are presenting a case of metastatic left-sided RCC with massive hypermetabolic tumor thrombus extending from left kidney to left renal vein and inferior vena cava giving an interesting “Suspension Bridge” appearance on PET/CT images.
Collapse
Affiliation(s)
- Maseeh Uz Zaman
- Department of Radiology, The Aga Khan University Hospital, Karachi, Pakistan
| | - Nosheen Fatima
- Department of Radiology, The Aga Khan University Hospital, Karachi, Pakistan
| | - Areeba Zaman
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Unaiza Zaman
- Department of Medicine, Civil Hospital, Karachi, Pakistan
| | - Rabia Tahseen
- Department of Medicine, Civil Hospital, Karachi, Pakistan
| | - Sidra Zaman
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| |
Collapse
|
11
|
Almeida ND, Adams C, Davis GL, Starke RM, Buro J, Nasr N, McRae D, Cernica G, Caputy A, Hong R, Sherman J. Effectiveness of Positron Emission Tomography/Computed Tomography as a Guide for Palliative Radiation Therapy for Spinal Metastases. World Neurosurg 2018; 115:e67-e72. [PMID: 29614361 DOI: 10.1016/j.wneu.2018.03.171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Accepted: 03/24/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVE As back pain is the presenting symptom in 95% of patients with epidural spinal metastases, appropriately identifying and treating the most symptomatic levels can provide significant palliation. The purpose of this study was to analyze the ability of combined positron emission tomography (PET)/computed tomography (CT) to identify spinal metastases with high metabolic activity and guide radiotherapy. We sought to correlate improvement in back pain with reduction in standard uptake value (SUV) after treatment. METHODS Retrospective review was performed of 72 patients with spinal metastases treated with stereotactic ablative radiation therapy at a single center between 2002 and 2014. PET/CT was used to calculate SUVs for spinal metastases, and treatment planning was based on PET/CT results. Preoperative and postoperative pain levels were assessed in all patients. RESULTS Reduction in pain scores was found in 78% of treated patients. A significant reduction in pain was identified in patients with >5 metastases compared with fewer lesions (P < 0.05). Degree of change in SUV did not correlate significantly with pain relief. However, comparing pretreatment and posttreatment PET/CT, patients with improved pain consistently displayed decreased SUV. CONCLUSIONS PET/CT was shown to be a useful adjunct in radiation treatment planning with change in SUV correlating with symptomatic improvement. This study paves the way for future prospective studies to further assess utility and cost-effectiveness of this imaging modality in radiation treatment planning for spinal metastases.
Collapse
Affiliation(s)
- Neil D Almeida
- Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Crystal Adams
- Department of Neurological Surgery, George Washington University Hospital, Washington, DC, USA
| | - Gregory L Davis
- Department of Neurological Surgery, George Washington University Hospital, Washington, DC, USA
| | - Robert M Starke
- Department of Neurological Surgery, University of Miami, Miami, Florida, USA
| | - Justin Buro
- Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Nadim Nasr
- Department of Radiation Oncology, Virginia Hospital Center, Arlington, Virginia, USA
| | - Don McRae
- Department of Radiation Oncology, Virginia Hospital Center, Arlington, Virginia, USA
| | - George Cernica
- Department of Radiation Oncology, Virginia Hospital Center, Arlington, Virginia, USA
| | - Anthony Caputy
- Department of Neurological Surgery, George Washington University Hospital, Washington, DC, USA
| | - Robert Hong
- Department of Radiation Oncology, Virginia Hospital Center, Arlington, Virginia, USA
| | - Jonathan Sherman
- Department of Neurological Surgery, George Washington University Hospital, Washington, DC, USA.
| |
Collapse
|
12
|
Bagheri MH, Ahlman MA, Lindenberg L, Turkbey B, Lin J, Cahid Civelek A, Malayeri AA, Agarwal PK, Choyke PL, Folio LR, Apolo AB. Advances in medical imaging for the diagnosis and management of common genitourinary cancers. Urol Oncol 2017; 35:473-491. [PMID: 28506596 PMCID: PMC5931389 DOI: 10.1016/j.urolonc.2017.04.014] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 04/05/2017] [Accepted: 04/15/2017] [Indexed: 01/01/2023]
Abstract
Medical imaging of the 3 most common genitourinary (GU) cancers-prostate adenocarcinoma, renal cell carcinoma, and urothelial carcinoma of the bladder-has evolved significantly during the last decades. The most commonly used imaging modalities for the diagnosis, staging, and follow-up of GU cancers are computed tomography, magnetic resonance imaging (MRI), and positron emission tomography (PET). Multiplanar multidetector computed tomography and multiparametric MRI with diffusion-weighted imaging are the main imaging modalities for renal cell carcinoma and urothelial carcinoma, and although multiparametric MRI is rapidly becoming the main imaging tool in the evaluation of prostate adenocarcinoma, biopsy is still required for diagnosis. Functional and molecular imaging using 18-fluorodeoxyglucose-PET and sodium fluoride-PET are essential for the diagnosis, and especially follow-up, of metastatic GU tumors. This review provides an overview of the latest advances in the imaging of these 3 major GU cancers.
Collapse
Affiliation(s)
- Mohammad H Bagheri
- Clinical Image Processing Service, Radiology and Imaging Sciences Department, Clinical Center, National Institutes of Health, Bethesda, MD
| | - Mark A Ahlman
- Nuclear Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD; Radiology and Imaging Sciences Department, Clinical Center, National Institutes of Health, Bethesda, MD
| | - Liza Lindenberg
- Molecular Imaging Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Baris Turkbey
- Molecular Imaging Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Jeffrey Lin
- Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Ali Cahid Civelek
- Radiology and Imaging Sciences Department, Clinical Center, National Institutes of Health, Bethesda, MD
| | - Ashkan A Malayeri
- Radiology and Imaging Sciences Department, Clinical Center, National Institutes of Health, Bethesda, MD
| | - Piyush K Agarwal
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Peter L Choyke
- Molecular Imaging Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Les R Folio
- Radiology and Imaging Sciences Department, Clinical Center, National Institutes of Health, Bethesda, MD
| | - Andrea B Apolo
- Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD.
| |
Collapse
|
13
|
Bernard S, Walker E, Raghavan M. An Approach to the Evaluation of Incidentally Identified Bone Lesions Encountered on Imaging Studies. AJR Am J Roentgenol 2017; 208:960-70. [DOI: 10.2214/ajr.16.17434] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
14
|
|
15
|
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. [DOI: 10.1097/mnm.0000000000000618] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
|
16
|
Passah A, Agarwal KK, ArunRaj ST, Kumar R, Bal C. A rare site of hyoid bone metastasis in patients with renal cell carcinoma on 18F-fluorodeoxyglucose-positron emission tomography/computed tomography scan. Indian J Nucl Med 2016; 31:319. [PMID: 27833328 PMCID: PMC5041431 DOI: 10.4103/0972-3919.190806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Averilicia Passah
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Krishan Kant Agarwal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | | | - Rakesh Kumar
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Chandrasekhar Bal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
17
|
Abstract
Unlike for most other malignancies, application of FDG PET/CT is limited for renal cell carcinoma (RCC), mainly due to physiological excretion of 18F-fluoro-2-deoxy-2-d-glucose (FDG) from the kidneys, which decreases contrast between renal lesions and normal tissue, and may obscure or mask the lesions of the kidneys. Published clinical observations were discordant regarding the role of FDG PET/CT in diagnosing and staging RCC, and FDG PET/CT is not recommended for this purpose based on current national and international guidelines. However, quantitative FDG PET/CT imaging may facilitate the prediction of the degree of tumor differentiation and allows for prognosis of the disease. FDG PET/CT has potency as an imaging biomarker to provide useful information about patient’s survival. FDG PET/CT can be effectively used for postoperative surveillance and restaging with high sensitivity, specificity, and accuracy, as early diagnosis of recurrent/metastatic disease can drastically affect therapeutic decision and alter outcome of patients. FDG uptake is helpful for differentiating benign or bland emboli from tumor thrombosis in RCC patients. FDG PET/CT also has higher sensitivity and accuracy when compared with bone scan to detect RCC metastasis to the bone. FDG PET/CT can play a strong clinical role in the management of recurrent and metastatic RCC. In monitoring the efficacy of new target therapy such as tyrosine kinase inhibitors (TKIs) treatment for advanced RCC, FDG PET/CT has been increasingly used to assess the therapeutic efficacy, and change in FDG uptake is a strong indicator of biological response to TKI.
Collapse
Affiliation(s)
- Yiyan Liu
- Nuclear Medicine Service, Department of Radiology, New Jersey Medical School, Rutgers University , Newark, NJ , USA
| |
Collapse
|
18
|
Adejoro O, Alishahi A, Soubra A, Konety B. Trends in PET Scan Usage for Imaging of Patients Diagnosed With Nonmetastatic Urologic Cancer. Clin Genitourin Cancer 2016; 14:38-47.e1. [DOI: 10.1016/j.clgc.2015.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 08/25/2015] [Accepted: 09/11/2015] [Indexed: 11/24/2022]
|
19
|
Alongi P, Picchio M, Zattoni F, Spallino M, Gianolli L, Saladini G, Evangelista L. Recurrent renal cell carcinoma: clinical and prognostic value of FDG PET/CT. Eur J Nucl Med Mol Imaging 2015; 43:464-73. [PMID: 26268680 DOI: 10.1007/s00259-015-3159-6] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 07/30/2015] [Indexed: 01/03/2023]
Abstract
PURPOSE The purpose of our study was 1) to evaluate the diagnostic performance of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT), 2) to assess the impact of FDG PET/CT on treatment decision-making, and 3) to estimate the prognostic value of FDG PET/CT in the restaging process among patients with renal cell carcinoma (RCC). METHODS From the FDG PET/CT databases of San Raffaele Hospital in Milan, Italy, and the Veneto Institute of Oncology in Padua, Italy, we selected 104 patients with a certain diagnosis of RCC after surgery, and for whom at least 24 months of post-surgical FDG PET/CT, clinical, and instrumental follow-up data was available. The sensitivity and specificity of FDG PET/CT were assessed by histology and/or other imaging as standard of reference. Progression-free survival (PFS) and overall survival (OS) were computed using the Kaplan-Meier method. Univariate and multivariate Cox proportional hazards models were used to identify predictors of outcome. RESULTS FDG PET/CT resulted in a positive diagnosis in 58 patients and a negative diagnosis in 46 patients. Sensitivity and specificity were 74% and 80%, respectively. FDG PET/CT findings influenced therapeutic management in 45/104 cases (43%). After a median follow-up period of 37 months (± standard deviation 12.9), 51 (49%) patients had recurrence of disease, and 26 (25%) had died. In analysis of OS, positive versus negative FDG PET/CT was associated with worse cumulative survival rates over a 5-year period (19% vs. 69%, respectively; p <0.05). Similarly, a positive FDG PET/CT correlated with a lower 3-year PFS rate. In addition, univariate and multivariate analysis revealed that a positive scan, alone or in combination with disease stage III-IV or nuclear grading 3-4, was associated with high risk of progression (multivariate analysis = hazard ratios [HRs] of 4.01, 3.7, and 2.8, respectively; all p < 0.05). CONCLUSIONS FDG PET/CT is a valuable tool both in treatment decision-making and for predicting survival and progression in patients affected by RCC.
Collapse
Affiliation(s)
- Pierpaolo Alongi
- Nuclear Medicine Department, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Maria Picchio
- Nuclear Medicine Department, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Fabio Zattoni
- Department of Oncological and Surgical Sciences, Urology Clinic, University of Padua, Padua, Italy
| | | | - Luigi Gianolli
- Nuclear Medicine Department, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giorgio Saladini
- Radiotherapy and Nuclear Medicine Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy, Gattamelata Street, 64, Padua, Italy
| | - Laura Evangelista
- Radiotherapy and Nuclear Medicine Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy, Gattamelata Street, 64, Padua, Italy.
| |
Collapse
|
20
|
Win AZ, Aparici CM. Clinical effectiveness of (18)f-fluorodeoxyglucose positron emission tomography/computed tomography in management of renal cell carcinoma: a single institution experience. World J Nucl Med 2015; 14:36-40. [PMID: 25709543 PMCID: PMC4337006 DOI: 10.4103/1450-1147.150535] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Positron emission tomography (PET) is currently the most advanced technique of metabolic imaging available for tumor diagnosis and follow-up. The aim of this study was to examine the versatility and accuracy of fluorodeoxyglucose (FDG) PET/computed tomography (CT) in the metastasis detection of renal cell carcinoma (RCC). We also compared our findings to other similar studies from the literature. This is the biggest study so far to examine the sensitivity and specificity of FDG PET/CT in the management of RCC. A retrospective review was carried out on all the FDG PET/CT studies done from January 1999 to January 2014 at our institution. Biopsy results were considered the gold standard. For our patients (n = 315) with biopsy results, FDG PET/CT studies exhibited 100% sensitivity, 100% specificity. Our results were better than results achieved by other studies. The use of FDG PET/CT in restaging and metastasis detection of RCC has many advantages, in addition to high accuracy. This imaging technique has great potential in influencing treatment decisions. We recommend the incorporation of FDG PET/CT in routine standard protocols for RCC.
Collapse
Affiliation(s)
- Aung Zaw Win
- Department of Radiology, San Francisco VA Medical Center, San Francisco, CA 94121, USA
| | - Carina Mari Aparici
- Department of Radiology, San Francisco VA Medical Center, San Francisco, CA 94121, USA ; Department of Radiology, University California San Francisco, San Francisco, CA 94143, USA
| |
Collapse
|
21
|
Ozturk H. Peripheral neuroectodermal tumour of the kidney (Ewing's sarcoma): Restaging with (18)F-fluorodeoxyglucose (FDG)-PET/CT. Can Urol Assoc J 2015; 9:E39-44. [PMID: 25624967 DOI: 10.5489/cuaj.2286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Primitive peripheral neuroectodermal tumour and Ewing's sarcoma (PNET/EWS) were originally described as two distinct pathologic entities, although both share common stem-cell precursor and unique chromosomal abnormality. Although its incidence has increased recently, its share in all sarcomas is 1%. It is usually seen in men and women in their twenties. We present a case of a 38-year-old woman with a left renal mass detected incidentally. Magnetic resonance imaging revealed a centrally located hypervascular renal mass with diameter of 6 cm with non-homogenous contrast enhancement containing necrotic and calcific areas. The patient was diagnosed as having PNET/EWS by histopathological examination following radical nephrectomy. Para-aortic lymph node metastasis was found on imaging by (18)F-fluorodeoxyglucose (FDG)-positron-emission tomography/computed tomography (PET/CT).
Collapse
Affiliation(s)
- Hakan Ozturk
- Department of Urology, School of Medicine, Sifa University, Izmir-Turkey
| |
Collapse
|
22
|
Casalino DD, Remer EM, Bishoff JT, Coursey CA, Dighe M, Harvin HJ, Heilbrun ME, Majd M, Nikolaidis P, Preminger GM, Raman SS, Sheth S, Vikram R, Weinfeld RM. ACR Appropriateness Criteria Post-Treatment Follow-Up of Renal Cell Carcinoma. J Am Coll Radiol 2014; 11:443-9. [DOI: 10.1016/j.jacr.2014.01.023] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 01/29/2014] [Indexed: 10/25/2022]
|
23
|
Wafaie A, Kassem H, Kotb M, Zeitoun R, Ismail S. Evaluation of the efficiency of FDG PET/CT in detection and characterization of skeletal metastases. The Egyptian Journal of Radiology and Nuclear Medicine 2014. [DOI: 10.1016/j.ejrnm.2013.11.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
|
24
|
Ouvrier M, Vignot S, Thariat J. Place de l'imagerie nucléaire et de ses évolutions pour le diagnostic et le suivi des métastases osseuses. Bull Cancer 2013; 100:1115-24. [DOI: 10.1684/bdc.2013.1847] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
25
|
Wang HY, Ding HJ, Chen JH, Chao CH, Lu YY, Lin WY, Kao CH. Meta-analysis of the diagnostic performance of [18F]FDG-PET and PET/CT in renal cell carcinoma. Cancer Imaging 2012; 12:464-74. [PMID: 23108238 PMCID: PMC3483599 DOI: 10.1102/1470-7330.2012.0042] [Citation(s) in RCA: 101] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Positron emission tomography (PET) using fluorodeoxyglucose (FDG) is useful for restaging renal cell carcinoma (RCC) and detecting metastatic diseases but is less satisfactory for detecting primary disease. We evaluated whether the integration of computed tomography (CT) scans with the PET system could increase the applicability of FDG-PET for RCC. METHODS The MEDLINE databases were searched for relevant studies published since 2001. Two reviewers independently assessed the methodological quality of each study identified. We then performed a meta-analysis of the sensitivity and specificity of FDG-PET findings as reported in all the selected studies. RESULTS Fourteen studies were eligible for inclusion. The pooled sensitivity and specificity of FDG-PET were 62% and 88% respectively, for renal lesions. For detecting extra-renal lesions, the pooled sensitivity and specificity of FDG-PET were 79% and 90%, respectively, based on the scans, and 84% and 91% based on the lesions. The use of a hybrid FDG-PET/CT to detect extra-renal lesions increased the pooled sensitivity and specificity to 91% and 88%, respectively, with good consistency. CONCLUSIONS For RCC, combining the FDG-PET and CT systems is helpful for detecting extra-renal metastasis rather than renal lesions. The hybrid PET/CT system has comparable sensitivity and specificity with PET in detecting extra-renal lesions of RCC. ADVANCES IN KNOWLEDGE The FDG-PET and PET/CT systems are both useful for detecting extra-renal metastasis in renal cell carcinoma.
Collapse
Affiliation(s)
- Hsin-Yi Wang
- Department of Nuclear Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Life Sciences, National Chung Hsing University, Taichung, Taiwan; H.Y. Wang and W.Y. Lin contributed equally to this work
| | | | | | | | | | | | | |
Collapse
|
26
|
Yang HL, Liu T, Wang XM, Xu Y, Deng SM. Diagnosis of bone metastases: a meta-analysis comparing ¹⁸FDG PET, CT, MRI and bone scintigraphy. Eur Radiol 2011; 21:2604-17. [PMID: 21887484 DOI: 10.1007/s00330-011-2221-4] [Citation(s) in RCA: 219] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Revised: 06/09/2011] [Accepted: 06/17/2011] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To perform a meta-analysis to compare (18)FDG PET, CT, MRI and bone scintigraphy (BS) for the diagnosis of bone metastases. METHODS Databases including MEDLINE and EMBASE were searched for relevant original articles published from January 1995 to January 2010. Software was used to obtain pooled estimates of sensitivity, specificity and summary receiver operating characteristic curves (SROC). RESULTS 67 articles consisting of 145 studies fulfilled all inclusion criteria. On per-patient basis, the pooled sensitivity estimates for PET, CT, MRI and BS were 89.7%, 72.9%, 90.6% and 86.0% respectively. PET=MRI>BS>CT. ("="indicated no significant difference, P > 0.05; ">" indicated significantly higher, P < 0.05). The pooled specificity estimates for PET, CT, MRI and BS were 96.8%, 94.8%, 95.4% and 81.4% respectively. PET = CT = MRI>BS. On per-lesion basis, the pooled sensitivity estimates for PET, CT, MRI and BS were 86.9%, 77.1%, 90.4% and 75.1% respectively. PET = MRI>BS>CT. The pooled specificity estimates for PET, CT, MRI and BS were 97.0%, 83.2%, 96.0% and 93.6% respectively. PET>MRI>BS>CT. CONCLUSION PET and MRI were found to be comparable and both significantly more accurate than CT and BS for the diagnosis of bone metastases.
Collapse
Affiliation(s)
- Hui-Lin Yang
- Department of Orthopaedics, The first affiliated hospital of Soochow University, No188, Shizi Street, Suzhou 215006, People's Republic of China.
| | | | | | | | | |
Collapse
|
27
|
Abstract
Radionuclide imaging of the kidneys with gamma cameras involves the use of labeled molecules seeking functionally critical molecular mechanisms to detect the pathophysiology of the diseased kidneys and achieve an early, sensitive, and accurate diagnosis. The most recent imaging technology, positron emission tomography, permits quantitative imaging of the kidney at a spatial resolution appropriate for the organ. H(2)(15)O, (82)RbCl, and [(64)Cu] ETS are the most important radiopharmaceuticals for measuring renal blood flow. The renin angiotensin system is the most important regulator of renal blood flow; this role is being interrogated by detecting angiotensin receptor subtype angiotensin subtype 1 receptor by the use of in vivo positron emission tomography. Membrane organic anion transporters are important for the function of the tubular epithelium; therefore, Tc99m MAG3 as well as some novel radiopharmaceuticals, such as copper-64 labeled mono oxo-tetraazamacrocyclic ligands, have been used for molecular renal imaging. In addition, other radioligands that interact with the organic cation transporters or peptide transporters have been developed. Focusing on early detection of kidney injury at the molecular level is an evolving field of great significance. Potential imaging targets are the kidney injury molecule 1, which is highly expressed in kidney injury and renal cancer but not in normal kidneys. Although pelvic clearance, in addition to parenchymal transport, is an important measure in obstructive nephropathy, techniques that focus on up-regulated molecules in response to tissue stress resulting from obstruction will be of great implication. Monocyte chemoattractant protein-1 is a well-suited molecule here. The greatest advances in molecular imaging of the kidneys have been recently achieved in detecting renal cancer. In addition to the ubiquitous [(18)F] fluorodeoxyglucose, other radioligands, such as [(11)C] acetate and anti-1-amino-3-[18F]fluorocyclobutane-1-carboxylic acid, have emerged. Radioimmunoimaging with [(124)I] G250 could lead to radioimmunotherapy for renal cancer. Considering the increasing age of general population, the incidence of kidney diseases, such as atherosclerosis, diabetic nephropathy, and cancer, is expected to increase. Successful management of these diseases offers an opportunity and a challenge for development of novel molecular imaging technologies.
Collapse
Affiliation(s)
- Zsolt Szabo
- Division of Nuclear Medicine, Department of Radiology, Johns Hopkins University School of Medicine, 601 N. CarolineStreet, Baltimore, MD 21287, USA.
| | | | | | | | | |
Collapse
|
28
|
Abstract
Renal cell carcinoma (RCC) diagnosis and management have undergone significant shifts in the recent past. The increasing rate of diagnosis of small renal masses, often in patients at high risk of morbidity with operative treatment, has led to studies, trials and discoveries in renal mass biopsy, active surveillance and minimally invasive thermal ablation. At the other end of the disease spectrum, targeted systemic therapies for metastatic RCC have supplanted cytokine-based treatment, with significant benefits to progression and survival. Recent reviews and trials have also cemented the role of partial nephrectomy as standard surgical management for most low-stage masses, and the roles of regional lymphadenectomy and adrenalectomy concomitant with nephrectomy have been clarified. This review aims to highlight recent evidence that has emerged in the management of this complicated oncologic issue.
Collapse
Affiliation(s)
- Michael J Leveridge
- Assistant Professor, Department of Urology, Kingston General Hospital, Queen's University, Kingston, ON
| | | |
Collapse
|
29
|
Vassiliou V, Andreopoulos D, Frangos S, Tselis N, Giannopoulou E, Lutz S. Bone metastases: assessment of therapeutic response through radiological and nuclear medicine imaging modalities. Clin Oncol (R Coll Radiol) 2011; 23:632-45. [PMID: 21530193 DOI: 10.1016/j.clon.2011.03.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2010] [Revised: 01/11/2011] [Accepted: 01/13/2011] [Indexed: 12/15/2022]
Abstract
Radiological and nuclear medicine imaging modalities used for assessing bone metastases treatment response include plain and digitalised radiography (XR), skeletal scintigraphy (SS), dual-energy X-ray absorptiometry (DEXA), computed tomography (CT), magnetic resonance imaging (MRI), [(18)F] fluorodeoxyglucose positron emission tomography (FDG-PET) and PET/CT. Here we discuss the advantages and disadvantages of these assessment modalities as evident through different clinical trials. Additionally, we present the more established response criteria of the International Union Against Cancer and the World Health Organization and compare them with newer MD Anderson criteria. Even though serial XR and SS have been used to assess the therapeutic response for decades, several months are required before changes are evident. Newer techniques, such as MRI or PET, may allow an earlier evaluation of response that may be quantified through monitoring changes in signal intensity and standard uptake value, respectively. Moreover, the application of PET/CT, which can follow both morphological and metabolic changes, has yielded interesting and promising results that give a new insight into the natural history of metastatic bone disease. However, only a few studies have investigated the application of these newer techniques and further clinical trials are needed to corroborate their promising results and establish the most suitable imaging parameters and evaluation time points. Last, but not least, there is an absolute need to adopt uniform response criteria for bone metastases through an international consensus in order to better assess treatment response in terms of accuracy and objectivity.
Collapse
Affiliation(s)
- V Vassiliou
- Department of Radiation Oncology, Bank of Cyprus Oncology Centre, Nicosia, Cyprus
| | | | | | | | | | | |
Collapse
|
30
|
Ozülker T, Ozülker F, Küçüköz Uzun A, Tatoğlu T, Ozpaçacı T. Evaluation of Response to Therapy in a Patient with Lung Cancer: Correlation of Sclerotic Bone Lesions with F 18 FDG PET/CT and Bone Scintigraphy. Mol Imaging Radionucl Ther 2011; 20:29-33. [PMID: 23486831 PMCID: PMC3590935 DOI: 10.4274/mirt.20.06] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2010] [Accepted: 12/22/2010] [Indexed: 12/01/2022] Open
Abstract
UNLABELLED A 64-year-old male patient with small cell lung cancer underwent Fluorine-18 fluorodeoxyglucose (F 18 FDG) positron emission tomography (PET)/CT scan which revealed multiple F 18 FDG uptake in the spine, both humeri, ribs, pelvis and proximal long bones. There was no obvious lytic or sclerotic bone destruction accompanying these lesions on CT component of the study. After the patient received six courses of chemotherapy a repeat F 18 FDG-PET/CT was performed for evaluation of therapy response. The PET/CT showed the presence of multiple sclerotic lesions on CT without FDG uptake, corresponding to the bone lesions on the previous PET/CT scan. A concomitant Tc 99m Methylene diphosphonate (Tc 99m MDP) bone scintigraphy (BS) revealed no pathologically increased Tc 99m MDP uptake in the skeletal system. The FDG avid lesions in the skeletal system, which were not sclerotic initially, were transformed into FDG non-avid sclerotic lesions after chemotherapy. This was attributed to the direct effect of previous successful therapy for bone metastases, leading to the transformation of metabolically active disease, into blastic metabolically inactive metastases. In conclusion, a F 18 FDG negative bone lesion, which is sclerotic on CT, may represent post-treatment osteoblastic change rather than active tumor and BS might play a role in the discrimination of these two situations. CONFLICT OF INTEREST None declared.
Collapse
Affiliation(s)
- Tamer Ozülker
- Okmeydani Training and Research Hospital, Department of Nuclear Medicine, Istanbul, Turkey
| | | | | | | | | |
Collapse
|
31
|
Sacco E, Pinto F, Totaro A, D'Addessi A, Racioppi M, Gulino G, Volpe A, Marangi F, D'Agostino D, Bassi P. Imaging of renal cell carcinoma: state of the art and recent advances. Urol Int 2010; 86:125-39. [PMID: 21150177 DOI: 10.1159/000322724] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND AIM Renal cell carcinoma (RCC) is the 13th most common cancer worldwide and accounts for 4% of all adult malignancies. Herein the state of the art and recent advances in cross-sectional radiological imaging applied to RCC are reviewed, including ultrasonography, computed tomography, magnetic resonance imaging, and positron emission tomography. METHODS Literature search of peer-reviewed papers published by October 2010. RESULTS In front of more conventional and widespread imaging tools, such as ultrasonography and computed tomography, an array of newer and attractive radiological modalities are under investigation and show promise to improve our ability to noninvasively detect renal tumors and its recurrences, accurately assess the extent of the disease, and reliably evaluate treatment response, particularly in the era of antiangiogenetic therapy. CONCLUSIONS Recent major advances in radiological imaging techniques have considerably improved our ability to diagnose, stage and follow-up RCC. Further studies are needed to evaluate the potential of most recent and still investigational imaging tools.
Collapse
Affiliation(s)
- Emilio Sacco
- Department of Urology, Agostino Gemelli Hospital, Catholic University Medical School, Rome, Italy. emilio.sacco @ gmail.com
| | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
van der Veldt AA, Meijerink MR, van den Eertwegh AJ, Boven E. Targeted therapies in renal cell cancer: recent developments in imaging. Target Oncol. 2010;5:95-112. [PMID: 20625845 PMCID: PMC2929340 DOI: 10.1007/s11523-010-0146-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2010] [Accepted: 06/24/2010] [Indexed: 01/14/2023]
Abstract
Targeted therapy has significantly improved the perspectives of patients with metastatic renal cell cancer (mRCC). Frequently, these new molecules cause disease stabilization rather than substantial tumor regression. As treatment options expand with the growing number of targeted agents, there is an increasing need for surrogate markers to early assess tumor response. Here, we review the currently available imaging techniques and response evaluation criteria for the assessment of tumor response in mRCC patients. For computed tomography (CT), different criteria are discussed including the Response Evaluation Criteria in Solid Tumors (RECIST), the Choi criteria, the modified Choi criteria, and the size and attenuation CT (SACT) criteria. Functional imaging modalities are discussed, such as dynamic contrast-enhanced CT (DCE-CT), dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), dynamic contrast-enhanced ultrasonography (DCE-US), and positron emission tomography (PET).
Collapse
|
33
|
Özülker T, Küçüköz Uzun A, Özülker F, Özpaçac T. Comparison of 18F-FDG-PET/CT with 99mTc-MDP bone scintigraphy for the detection of bone metastases in cancer patients. Nucl Med Commun 2010; 31:597-603. [DOI: 10.1097/mnm.0b013e328338e909] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
34
|
Mueller-Lisse UG, Mueller-Lisse UL. Imaging of advanced renal cell carcinoma. World J Urol 2010; 28:253-61. [PMID: 20458484 DOI: 10.1007/s00345-010-0557-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2010] [Accepted: 04/11/2010] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES To describe current radiological cross-sectional imaging in the detection and staging of advanced renal cell carcinoma (RCC), defined here as RCC reaching beyond the renal capsule, whether by immediate extension or by metastasis. METHODS Review and summary of current radiological and urological literature, including original articles and reviews, retrieved from the medical data base "PubMed". RESULTS Multi-detector-row computed tomography (MDCT) shows a sensitivity of up to 100% and specificity of about 90% for retroperitoneal disease, venous tumour thrombus, and metastasis, but limited accuracy for lymphadenopathy in RCC. Magnetic resonance imaging (MRI) is applied as a problem-solving modality, with particular strength in imaging metastasis to brain and bone. However, dynamic, contrast-enhanced- (DCE-) and arterial-spin-labelling (ASL-) MRI may help to monitor early response to angiogenesis inhibitor drugs. Ultrasonography (US) shows limited capability of identifying retroperitoneal disease, venous tumour thrombus extension, and metastasis. Positron Emission Tomography with 18-fluoro-desoxy-glucose (FDG-PET) demonstrates modest accuracy for metastasis of RCC, with positive studies being suspicious, while negative studies cannot reliably exclude disease. CONCLUSIONS MDCT represents the diagnostic mainstay for the detection and staging of RCC. In the wake of new systemic therapies for advanced RCC, including angiogenesis inhibitor drugs, monitoring treatment response may become a new task for cross-sectional imaging.
Collapse
|
35
|
Anthony MP, Mak H, Khong PL. An unusual case of synchronous renal cell carcinoma in a horseshoe kidney and intrahepatic cholangiocarcinoma. Clin Nucl Med 2009; 34:922-3. [PMID: 20139836 DOI: 10.1097/RLU.0b013e3181bed097] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
36
|
Rajarubendra N, Bolton D, Lawrentschuk N. Diagnosis of bone metastases in urological malignancies--an update. Urology. 2010;76:782-790. [PMID: 20346492 DOI: 10.1016/j.urology.2009.12.050] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2009] [Revised: 12/17/2009] [Accepted: 12/30/2009] [Indexed: 12/17/2022]
Abstract
The spread of urological malignancies to bone is a poor prognostic factor. Early detection of metastatic bony lesions assists with tailoring patient management and potentially improving quality of life. Newer therapies such as zolderonic acid for prostate cancer have reinvigorated the importance of clinicians treating bony disease. An array of biochemical and imaging options are available and the order, sensitivity and cost of such investigations need to be understood to maximise clinical benefit. Furthermore, the ideal time to investigate for bony metastases has often been controversial. Although simple history and examination, serum calcium and alkaline phosphatase and plain radiography with bone scintigraphy remain at the forefront of diagnosing bony disease, evolving diagnostic modalities, such as positron emission tomography and newer bone markers need to be considered. The aim of this review is to clarify the role of various investigations and to give clinicians a current analysis of the timing of such investigations in the context of evolving diagnostic modalities and accepted guidelines for urological malignancy.
Collapse
|
37
|
Chua S, Gnanasegaran G, Cook GJ. Miscellaneous Cancers (Lung, Thyroid, Renal Cancer, Myeloma, and Neuroendocrine Tumors): Role of SPECT and PET in Imaging Bone Metastases. Semin Nucl Med 2009; 39:416-30. [DOI: 10.1053/j.semnuclmed.2009.07.002] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
38
|
Sohaib SA, Cook G, Allen SD, Hughes M, Eisen T, Gore M. Comparison of whole-body MRI and bone scintigraphy in the detection of bone metastases in renal cancer. Br J Radiol 2009; 82:632-9. [PMID: 19221182 DOI: 10.1259/bjr/52773262] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
This study aims to compare the sensitivity of whole-body MRI with bone scintigraphy in the detection of bone metastases in patients with renal cancer. A prospective study was carried out in 47 patients with renal cancer (mean age 62 years, range 29-79 years). All patients had assessment of the skeleton with whole-body bone scintigraphy (with technetium-99m methylene diphosphonate) and whole-body MRI (coronal T(1) weighted and short tau inversion recovery sequences). The number and sites of bony metastases were assessed on each imaging investigation independently. Sites of extra-osseous metastasis on MRI were also noted. The imaging findings were correlated with other imaging modalities and follow-up. 15 patients (32%) had bone metastases at 34 different sites. Both scintigraphy and MRI were highly specific (94% and 97%, respectively), but the sensitivity of MRI (94%) was superior (p = 0.007) to that of scintigraphy (62%). MRI identified more metastases in the spine and appendicular skeleton, whereas scintigraphy showed more lesions in the skull/facial and thoracic bones. MRI identified extra-osseous metastases in 33 patients (70%), these were mainly lung and retroperitoneal in site. Whole-body MRI is a more sensitive method for detection of bone metastases in renal cancer than bone scintigraphy, and also allows the assessment of soft-tissue disease.
Collapse
Affiliation(s)
- S A Sohaib
- Department of Imaging, Royal Marsden Hospital, London, UK.
| | | | | | | | | | | |
Collapse
|
39
|
YOKOYAMA T, WATANABE A, MIGITA K, NAKAGAWA K, INOUE T, MUKOGAWA T, OHYAMA T, ISHIKAWA H. CLINICOPATHOLOGICAL EVALUATION OF BONE METASTASIS IN GASTRIC CANCER PATIENTS. ACTA ACUST UNITED AC 2009. [DOI: 10.3919/jjsa.70.656] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
40
|
Bouchelouche K, Oehr P. Positron emission tomography and positron emission tomography/computerized tomography of urological malignancies: an update review. J Urol 2007; 179:34-45. [PMID: 17997425 DOI: 10.1016/j.juro.2007.08.176] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2007] [Indexed: 10/22/2022]
Abstract
PURPOSE Appropriate imaging in uro-oncology is a crucial component at primary diagnosis, followup and recurrence to achieve an accurate assessment of the disease and determine the most effective treatment. We summarize recent developments in positron emission tomography and positron emission tomography/computerized tomography for prostate, bladder and renal cancer. MATERIALS AND METHODS The recent published literature on positron emission tomography and positron emission tomography/computerized tomography in uro-oncology was searched and reviewed. RESULTS For prostate cancer 18F-fluorodeoxyglucose is not highly effective for primary diagnosis but it has a limited role in staging and recurrence detection. Promising results have been shown by 11C-choline, 18F-fluorocholine, 11C-acetate and 18F-fluoride. The role of 11C-methionine, 18F-fluoro-5-alpha-dihydrotestosterone and anti-1-amino-3-18F-fluorocyclobutane-1-carboxylic acid remains to be elucidated. For bladder cancer 18F-fluorodeoxyglucose positron emission tomography is useful for identifying distant metastases but not for detecting primary tumors due to the urinary excretion of 18F-fluorodeoxyglucose. The role of 11C-choline and 11C-methionine remains to be evaluated further in clinical studies. For renal cancer 18F-fluorodeoxyglucose is of limited use for primary diagnosis but it has a role in staging and restaging of the disease. More clinical data are needed to investigate the roles of 18F-fluoromisonidazole and 18F-fluorothymidine. CONCLUSIONS Several advances in positron emission tomography and positron emission tomography/computerized tomography for urological cancer have been made in recent years. However, larger clinical trials are needed to establish the role of this imaging method for urological malignancy. In the near future the new radiotracers and further advancement in this imaging technique are expected to improve the performance of positron emission tomography/computerized tomography in uro-oncology.
Collapse
Affiliation(s)
- Kirsten Bouchelouche
- Positron Emission Tomography and Cyclotron Unit, Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark.
| | | |
Collapse
|
41
|
Abstract
OBJECTIVE Metastatic disease occurs in a significant percentage of patients with renal cell carcinoma. Recent advances in systemic therapies for metastatic renal cell carcinoma are likely to have a significant effect on the way patients with advanced disease are imaged. These new therapies have shown a significant increase in progression-free survival. CONCLUSION Imaging is likely to play an increasing role in the management, diagnosis, and monitoring of response to treatment of metastatic renal cell carcinoma.
Collapse
Affiliation(s)
- Nyree Griffin
- Department of Diagnostic Imaging, Royal Marsden Hospital, 203 Fulham Rd., London SW3 6JJ, United Kingdom
| | | | | |
Collapse
|
42
|
Ozawa N, Okamura T, Koyama K, Hamazawa Y, Senzaki H, Tanabe S, Ikemoto S, Inoue Y. Usefulness of F-18 FDG-PET in a long-term hemodialysis patient with renal cell carcinoma and pheochromocytoma. Ann Nucl Med 2007; 21:239-43. [PMID: 17581724 DOI: 10.1007/s12149-007-0011-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2006] [Accepted: 02/16/2007] [Indexed: 10/23/2022]
Abstract
A patient who had been on long-term hemodialysis (HD) was diagnosed as having renal cell carcinoma (RCC) and pheochromocytoma. Abdominal computed tomography scanning demonstrated a right renal mass and a right adrenal mass, whereas positron emission tomography (PET) using F-18 fluorodeoxyglucose (FDG) revealed increased accumulation in both the renal and adrenal masses. FDG-PET is useful for detecting RCC in HD patients because FDG is not excreted in the urine, but it is difficult to distinguish pheochromocytoma from an adrenal metastasis by this imaging method.
Collapse
Affiliation(s)
- Nozomi Ozawa
- PET Center, Saiseikai Nakatsu Hospital, 2-10-39 Shibata Kita-ku, Osaka 530-0012, Japan.
| | | | | | | | | | | | | | | |
Collapse
|
43
|
Abstract
This review focuses on several aspects of molecular imaging. First, current positron emission tomography (PET)/CT scanner technology and several novel imaging techniques that are being developed are briefly discussed. Next, current clinical indications for (18)F FDG PET and PET/CT that are relevant to the surgical oncologist are discussed. Finally, advances in molecular imaging that may herald the next generation of PET radiotracers beyond (18)F FDG are reviewed.
Collapse
Affiliation(s)
- Andrei Iagaru
- Division of Nuclear Medicine, Stanford University Medical Center, 300 Pasteur Drive, Room H-0101, Stanford, CA 94305, USA
| | | |
Collapse
|
44
|
Abstract
In recent years, there have been multiple advances in imaging technologies that have improved the surveillance for recurrence of neoplasms. Multidetector row CT and dynamic contrast enhanced MRI now provide excellent anatomic detail and are beginning to show functional detail as the rapid capture of images following contrast administration improves. Positron emission tomography is emerging as a useful tool in evaluating patients with suspected metastatic disease to the abdomen and bone, particularly when combined with CT. The role of ultrasound in the surveillance of renal cell carcinoma is yet unclear, but its role may be expanding with use of newly developed contrast drugs. Herein we review the relevance of these modalities to the follow-up of patients with renal cell carcinoma.
Collapse
Affiliation(s)
- Matthew K Tollefson
- Department of Urology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
| | | | | |
Collapse
|
45
|
Kim GH, Jo MK, Cheon GJ, Lee HM. Clinical Role of F-18 Fluorodeoxyglucose Positron Emission Tomography for Follow-up of Patients with Renal Cell Carcinoma. Korean J Urol 2007. [DOI: 10.4111/kju.2007.48.8.765] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Geon Hun Kim
- Department of Urology, Korea Cancer Center Hospital, Seoul, Korea
| | - Moon Ki Jo
- Department of Urology, Korea Cancer Center Hospital, Seoul, Korea
| | - Gi Jeong Cheon
- Department of Nuclear Medicine, Korea Cancer Center Hospital, Seoul, Korea
| | - Hyun Moo Lee
- Department of Urology, College of Medicine, Sungkyunkwan University, Seoul, Korea
| |
Collapse
|
46
|
Abstract
FDG-PET has a limited role in diagnosis of prostate cancer mainly because of the low uptake of FDG in the tumor and normal excretion of FDG through urine. FDG-PET has shown some promise in the assessment of lymph nodes and bone metastases. There is a large degree of variability when FDG-PET is compared with bone scintigraphy. New C11-labeled radiotracers (acetate, choline, and methionine) have shown promising initial results but further studies are required to determine their role in such settings. These radiotracers provide a unique opportunity for dynamic, multitracer, and quantitative studies, which improve the sensitivity and specificity on PET in this population. Short half-lives and of C-11, however with the limits to their use requires an on-site cyclotron. Recent synthesis schemes with [18F]-labeling, however, may overcome this limitation. FDG-PET has a significant potential to assist with the diagnosis and management of testicular cancer. PET has been most useful in defining the presence or absence of disease in patients with residual masses. PET has shown promising results for the initial diagnosis of this cancer, but further for studies ar required to determine its role in the management of this malignancy. PET can be used in conjunction with conventional imaging techniques to diagnose retroperitoneal masses in patients with primary testicular cancer. FDG-PET has shown very encouraging results in a limited number of studies, and has also demonstrated a good sensitivity for initial staging. FDG-PET seems to be superior to conventional imaging modalities for detecting local disease and recurrence, and distant metastases.
Collapse
Affiliation(s)
- Rakesh Kumar
- Division of Nuclear Medicine, Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, 110 Donner Building, Philadelphia, PA 19104, USA
| | | | | |
Collapse
|
47
|
Machtens S, Boerner AR, Hofmann M, Knapp WH, Jonas U. Positronenemissionstomographie (PET) zur Diagnostik und zum Therapiemonitoring bei urologischen Tumoren. Urologe A 2004; 43:1397-409. [PMID: 15502907 DOI: 10.1007/s00120-004-0714-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Positron emission tomography (PET) using ((18)F)2-fluoro-D-2-desoxyglucose (FDG) has been shown to be a highly sensitive and specific imaging modality in the diagnosis of primary and recurrent tumors and in the control of therapies in numerous non-urologic cancers. It was the aim of this review to validate the significance of PET as a diagnostic tool in malignant tumors of the urogenital tract. A systematic review of the current literature concerning the role of PET for malignant tumors of the kidney, testicles, prostate, and bladder was carried out. The role of FDG PET for renal cell cancer can be seen in the detection of recurrences after definitive local therapy and metastases. The higher sensitivity of PET in comparison to other therapeutic modalities (CT, ultrasound, MRI) in recurrent and metastatic renal cell cancer suggests a supplemental role of this diagnostic procedure to complement other imaging modalities.The clinical value of PET is established for the identification of vital tumor tissue after chemotherapy of seminomatous germ cell tumors. This diagnostic method has little significance for primary tumor staging and diagnosis of non-seminomatous germ cell tumor because of the high probability of false-negative results in adult teratomas. FDG PET is not sensitive enough in the diagnosis of primary or recurrent tumors in prostate or bladder cancer. Also PET did not prove to be superior to conventional bone scintigram in the detection of mostly osteoblastic metastases in prostate cancer. The recent use of alternative tracers, which are partly not eliminated by urinary secretion (acetate, choline) has increased the sensitivity and specificity of PET also in this tumor entity so that further clinical investigations are needed to validate these technical modifications in their significance for this imaging modality. PET appears to be sufficiently evaluated only for the diagnostic follow-up of patients with seminomatous germ cell tumors after chemotherapy to regard it is the diagnostic tool of first choice. For all other tumors of the urogenital tract this proof is still awaited.
Collapse
Affiliation(s)
- S Machtens
- Klinik für Urologie und Kinderurologie, Medizinische Hochschule, Hannover.
| | | | | | | | | |
Collapse
|
48
|
Bombardieri E, Aktolun C, Baum RP, Bishof-Delaloye A, Buscombe J, Chatal JF, Maffioli L, Moncayo R, Morteímans L, Reske SN. Bone scintigraphy: procedure guidelines for tumour imaging. Eur J Nucl Med Mol Imaging 2004; 30:BP99-106. [PMID: 14989222 DOI: 10.1007/s00259-003-1347-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
|
49
|
Abstract
Metastatic bone disease is common in cancer patients and causes substantial disease-related morbidity and mortality. However, several effective treatments are available for the management of these patients. Bisphosphonates, which inhibit osteoclast-mediated resorption of bone matrix, are especially important because they decrease the incidence of skeletal-related events in many tumour types and can complement antineoplastic therapies. At present, assessment of treatment for bone metastases is hindered by a lack of effective, rapid methods to measure disease response. We discuss the difficulties of current measures of response assessment and describe the development of new radiological and biochemical markers of bone metastases. Assays that detect type I collagen telopeptides as markers of bone resorption seem to be most promising at present.
Collapse
Affiliation(s)
- Andrew Clamp
- Cancer Research UK, Department of Medical Oncology, Christie Hospital, Manchester, UK
| | | | | | | | | |
Collapse
|
50
|
Abstract
Positron emission tomography (PET) using F-18 fluorodeoxyglucose (FDG) is a very effective imaging modality in the diagnosis, staging, and monitoring of a variety of malignant conditions. The principle of imaging is based on the enhanced utilization of glucose by cancer. In this report, we describe a patient with renal cell carcinoma who showed FDG uptake isometabolic to normal liver.
Collapse
Affiliation(s)
- H K Cheow
- Departments of Nuclear Medicine, Addenbrooke's Hospital, Cambridge, UK
| | | | | |
Collapse
|