Kang David E, White Richard L, Zuger James H, Sasser Howell C, Teigland Chris M
Department of Urology, Carolinas Medical Center, Charlotte, North Carolina, USA.
J Urol. 2004 May;171(5):1806-9. doi: 10.1097/01.ju.0000120241.50061.e4.
We evaluate the role of fluorodeoxyglucose F 18 positron emission tomography (PET) in patients with renal cell carcinoma (RCC) by retrospective review. To our knowledge this series is the largest reviewing the use of PET in patients with RCC.
A total of 66 patients who underwent 90 PET scans for suspected or known RCC were identified. Dictated reports of PET, chest computerized tomography (CT), abdominal/pelvic CT and bone scan were examined with confirmation of results by histopathology or followup of at least 1 year. The accuracies of PET and conventional imaging modalities were compared.
PET exhibited a sensitivity of 60% and specificity of 100% for primary RCC tumors (abdominal CT demonstrated 91.7% sensitivity and 100% specificity). For retroperitoneal lymph node metastases and/or renal bed recurrence, PET was 75.0% sensitive and 100.0% specific (92.6% sensitivity and 98.1% specificity for abdominal CT). PET had a sensitivity of 75.0% and a specificity of 97.1% for metastases to the lung parenchyma compared to 91.1% and 73.1%, respectively, for chest CT. PET had a sensitivity of 77.3% and specificity of 100.0% for bone metastases, compared to 93.8% and 87.2% for combined CT and bone scan. In 39 scans (32 patients) PET failed to detect RCC lesions identified by conventional imaging.
The role of fluorodeoxyglucose F 18 PET in the detection of RCC is limited by low sensitivity. With superior specificity PET may have a complementary role as a problem solving tool in cases that are equivocal on conventional imaging.
通过回顾性研究评估氟脱氧葡萄糖F 18正电子发射断层扫描（PET）在肾细胞癌（RCC）患者中的作用。据我们所知，本系列研究是对PET在RCC患者中的应用进行回顾的最大规模研究。
共确定了66例因疑似或已知RCC而接受90次PET扫描的患者。检查了PET、胸部计算机断层扫描（CT）、腹部/盆腔CT和骨扫描的口述报告，并通过组织病理学或至少1年的随访确认结果。比较了PET和传统成像方式的准确性。
PET对原发性RCC肿瘤的敏感性为60%，特异性为100%（腹部CT显示敏感性为91.7%，特异性为100%）。对于腹膜后淋巴结转移和/或肾床复发，PET的敏感性为75.0%，特异性为100.0%（腹部CT的敏感性为92.6%，特异性为98.1%）。与胸部CT分别为91.1%和73.1%相比，PET对肺实质转移的敏感性为75.0%，特异性为97.1%。与CT和骨扫描联合检查分别为93.8%和87.2%相比，PET对骨转移的敏感性为77.3%，特异性为100.0%。在39次扫描（32例患者）中，PET未能检测到传统成像发现的RCC病变。
氟脱氧葡萄糖F 18 PET在RCC检测中的作用因敏感性低而受到限制。由于具有较高的特异性，PET在传统成像结果不明确的情况下作为问题解决工具可能具有辅助作用。
