Lagerveld Brunolf W, Sivro Ferida, van der Zee Johan A, Baars Phillippe C
Department of Urology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands; Department of Nuclear Medicine, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
J Kidney Cancer VHL. 2015 Dec 10;2(4):174-186. doi: 10.15586/jkcvhl.2015.42. eCollection 2015.
The aim of this study was to describe the characteristics of positron emission tomography (PET) molecular imaging combined with low-dose computed tomography (CT) in small renal mass (SRM) treated with cryoablation (CA). Currently, treatment success is defined by the absence of contrast enhancement at CT. However, the use of contrast is relatively contraindicated in patients with renal function impairment, mandating alternative follow-up strategies. Several reasons were identified as criteria for performing PET-CT before and/or after SRM-CA in 9 patients, and the results were retrospectively studied. The histology revealed renal cell carcinoma in 7 patients and oncocytoma in 2 patients. In 6 patients, a PET-CT was performed before and after CA. In one patient, the PET-CT was performed only before CA and in 2 patients only after CA. Before CA, clearly there was metabolic uptake of fluorine-18 fluorodeoxyglucose (F-FDG) in the SRM in all patients. Following CA, the absence of F-FDG uptakes in the SRM could clearly be noticed. However, the tracer cannot always be distinguished from focal recurrence or reactive inflammatory tissue. In one patient, asymptomatic metastatic bone lesions were noticed when performing PET-CT at follow-up. This pilot study with F-FDG PET-CT for the follow-up of SRM cryosurgery showed that F-FDG PET-CT imaging could be used to characterize cryoablative tissue injury at different times after CA.
本研究旨在描述正电子发射断层扫描（PET）分子成像联合低剂量计算机断层扫描（CT）在接受冷冻消融（CA）治疗的小肾肿块（SRM）中的特征。目前，治疗成功的定义是CT检查无强化。然而，对于肾功能损害的患者，使用造影剂相对禁忌，因此需要采用其他随访策略。确定了9例患者在SRM-CA之前和/或之后进行PET-CT检查的几个标准，并对结果进行了回顾性研究。组织学检查显示，7例患者为肾细胞癌，2例患者为嗜酸细胞瘤。6例患者在CA前后均进行了PET-CT检查。1例患者仅在CA前进行了PET-CT检查，2例患者仅在CA后进行了PET-CT检查。在CA之前，所有患者的SRM中均明显存在氟-18氟脱氧葡萄糖（F-FDG）的代谢摄取。CA后，可以明显注意到SRM中F-FDG摄取消失。然而，示踪剂并不总是能与局灶性复发或反应性炎症组织区分开来。在1例患者中，随访时进行PET-CT检查发现了无症状的转移性骨病变。这项关于F-FDG PET-CT用于SRM冷冻手术随访的初步研究表明，F-FDG PET-CT成像可用于在CA后的不同时间表征冷冻消融组织损伤。
