Special issue "The advance of solid tumor research in China": 68Ga‐PSMA‐11 PET/CT for evaluating primary and metastatic lesions in different histological subtypes of renal cell carcinoma. Issue 1 (16th July 2022)

• Record Type: Journal Article
• Authors: Li, Yilin; Zheng, Rongliang; Zhang, Yijun; Huang, Chaoyun; Tian, Li; Liu, Ruiqi; Liu, Yang; Zhang, Zhiling; Han, Hui; Zhou, Fangjian; He, Liru; Dong, Pei
• Other Names: Qin Shuqui guestEditor.; Li Jin guestEditor.; Guo Jun guestEditor.; Ma Jun guestEditor.; Zhou Caicun guestEditor.
• Is Part Of: International journal of cancer. Volume 152:Issue 1(2023)
• Page Start: 42
• Page End: 50
• Publication Date: 2022-07-16
• Subjects: 68Ga‐PSMA‐11 PET/CT -- accuracy -- cancer staging -- renal cell carcinoma -- tumor‐to‐background SUVmax ratio; Cancer -- Periodicals; Cancer -- Prevention -- Periodicals; 616.994
• DOI: 10.1002/ijc.34189
• Languages: English
• ISSNs: 0020-7136

Abstract

Abstract: Conventional imaging examinations are not sensitive enough for the early detection of recurrent or metastatic lesions in renal cell carcinoma (RCC) patients. We aimed to explore the role of 68 Ga‐prostate specific membrane antigen (PSMA)‐11 positron emission tomography (PET)/computed tomography (CT) in the detection of primary and metastatic lesions in such patients. We retrospectively analyzed 50 RCC patients who underwent 68 Ga‐PSMA‐11 PET/CT from November 2017 to December 2020. We observed a higher median accuracy and tumor‐to‐background maximum standard uptake value (SUVmax ) ratio (TBR) of 68 Ga‐PSMA‐11 PET/CT in clear cell RCC (ccRCC; 96.57% and 6.00, respectively) than in non‐clear cell RCC (ncRCC; 82.05% and 2.99, respectively). The accuracies in detecting lesions in the renal region, bone, lymph nodes and lungs in ccRCC were 100.00%, 95.00%, 98.08% and 75.00%, respectively, and those in the renal region, bone and lymph nodes in ncRCC were 100.00%, 86.67% and 36.36%, respectively. The median TBRs of the lesions from the above locations were 0.38, 10.96, 6.69 and 13.71, respectively, in ccRCC and 0.13, 4.02 and 0.73, respectively, in ncRCC. The PSMA score evaluated with immunohistochemistry was correlated with the SUVmax ( P = .046) in RCC. Higher PSMA scores were observed in ccRCC than in ncRCC ( P = .031). 68 Ga‐PSMA‐11 PET/CT resulted in changes in clinical management in 12.9% (4/31) of cases because of the discovery of new metastases not detected with conventional imaging. These results indicate that 68 Ga‐PSMA‐11 PET/CT is a promising method for the detection of metastatic lesions in ccRCC, especially for those in the bone and lymph nodes. Abstract : What's new? Accurate staging and assessment of metastases are important in guiding clinical treatment of patients with renal cell carcinoma (RCC). Early detection of metastatic lesions in RCC, however, presents unique challenges, owing to small lesion size, which escapes conventional imaging. Here, the authors investigated 68Ga‐PSMA‐11, a positron emission tomography (PET) ligand targeted toward prostate‐specific membrane antigen (PMSA) in the tumor neovasculature, for the detection of RCC lesions. Compared with conventional imaging, 68Ga‐PSMA‐11 PET/CT exhibited superior sensitivity and accuracy in metastatic lesion detection in clear cell RCC. Accuracy in the detection of lesions in the lymph nodes and bone was notably high.