使用18F-FDG PET/CT对肾细胞癌进行术前评估。
Preoperative evaluation of renal cell carcinoma by using 18F-FDG PET/CT.
作者信息
Takahashi Miwako, Kume Haruki, Koyama Keitaro, Nakagawa Tohru, Fujimura Tetsuya, Morikawa Teppei, Fukayama Masashi, Homma Yukio, Ohtomo Kuni, Momose Toshimitsu
机构信息
From the *Division of Nuclear Medicine, Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan, †Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan, and ‡Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
出版信息
Clin Nucl Med. 2015 Dec;40(12):936-40. doi: 10.1097/RLU.0000000000000875.
PURPOSE
This study aimed to characterize the FDG uptake of renal cell carcinoma (RCC) by the pathological subtype and nuclear grade.
PATIENTS AND METHODS
We retrospectively identified patients who underwent F-FDG PET and subsequent partial or radical nephrectomy for renal tumors. The relationships of the SUV of renal tumor with subtypes, nuclear grade, and clinicopathological variables were investigated.
RESULTS
Ninety-two tumors were analyzed, including 52 low-grade (G1 and G2) and 18 high-grade (G3 and G4) clear cell RCC; 7 chromophobe, 5 papillary, and 1 unclassified RCC; and 9 benign tumors (7 angiomyolipoma and 2 oncocytoma). The SUVs of high-grade clear cell RCC (mean ± SD, 6.8 ± 5.1) and papillary RCC (6.6 ± 3.7) were significantly higher than that of the controls (2.2 ± 0.3). The SUV of high-grade clear cell RCC was higher than that of low-grade tumors (median, 4.0 vs. 2.2; P < 0.001). The optimal SUV cutoff value of 3.0 helped to differentiate high-grade from low-grade clear cell RCC, with 89% sensitivity and 87% specificity. On multiple regression analysis, a high grade was the most significant predictor of SUV for clear cell RCC.
CONCLUSIONS
FDG uptake higher than that observed in normal kidney tissues suggests a high-grade clear cell RCC or papillary RCC subtype. FDG-PET using SUV may have a role in prediction of pathological grade of renal tumor.
目的
本研究旨在按病理亚型和核分级对肾细胞癌（RCC）的氟代脱氧葡萄糖（FDG）摄取情况进行特征描述。
患者与方法
我们回顾性地确定了接受F-FDG PET检查并随后因肾肿瘤接受部分或根治性肾切除术的患者。研究了肾肿瘤的标准化摄取值（SUV）与亚型、核分级及临床病理变量之间的关系。
结果
共分析了92个肿瘤，包括52个低级别（G1和G2）和18个高级别（G3和G4）透明细胞RCC；7个嫌色细胞癌、5个乳头状癌和1个未分类的RCC；以及9个良性肿瘤（7个血管平滑肌脂肪瘤和2个嗜酸细胞瘤）。高级别透明细胞RCC（均值±标准差，6.8±5.1）和乳头状RCC（6.6±3.7）的SUV显著高于对照组（2.2±0.3）。高级别透明细胞RCC的SUV高于低级别肿瘤（中位数，4.0对2.2；P<0.001）。SUV临界值3.0有助于区分高级别与低级别透明细胞RCC，敏感性为89%，特异性为87%。在多元回归分析中，高级别是透明细胞RCC的SUV最显著的预测因素。
结论
FDG摄取高于正常肾组织提示为高级别透明细胞RCC或乳头状RCC亚型。使用SUV的FDG-PET可能在预测肾肿瘤的病理分级中发挥作用。
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