Qiu Yongkang, Zhang Xiaoyue, Cheng Jia, Huang Wenpeng, Chen Zhao, Song Lele, Yang Qi, Sun Xinyao, Wang Aixiang, Wang Tianyao, Kang Lei
Department of Nuclear Medicine, Peking University First Hospital Beijing 100034, China.
Department of Urology Pathology, Peking University First Hospital Beijing 100034, China.
Am J Nucl Med Mol Imaging. 2025 Feb 25;15(1):28-36. doi: 10.62347/KQJB5668. eCollection 2025.
This study aims to explore the diagnostic performance of F-FDG PET/CT in distinguishing collecting duct carcinoma (CDC) from clear cell renal cell carcinoma (ccRCC).
A retrospective analysis was conducted on 11 patients with CDC and 27 patients with ccRCC who underwent F-FDG PET/CT examinations. Clinical indicators and the SUVmax, tumor-to-liver standardized uptake value ratio (TLR), tumor-to-kidney standardized uptake value ratio (TKR), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) values of the primary tumor, whole-body MTV (WBMTV), and whole-body TLG (WBTLG) based on a baseline PET scan, were recorded and compared between the two groups. To assess the discriminative power of these metabolic parameters between CDC and ccRCC, we performed a receiver operating characteristic (ROC) curve analysis.
The median age of the 11 CDC patients was 59 years. All CDC patients were in advanced stages (18% stage III and 82% stage IV). Compare with ccRCC patients, CDC patients had higher lymph node metastases rates (72.7% vs. 22.2%, = 0.008) and distant metastases rates (81.8% vs. 22.2%, = 0.001). The primary tumor in CDC also showed higher SUVmax (10.5 vs. 4.0, < 0.001), TLR (3.9 vs. 1.4, < 0.001), TKR (4.4 vs. 1.5, < 0.001), MTV (53.2 vs. 9.5, = 0.021), and TLG (305.7 vs. 30.4, = 0.0069) than ccRCC. The WBMTV and WBTLG of CDC patients were also higher than the ccRCC group (144.1 vs. 9.5, = 0.0013 and 528.4 vs. 30.4, = 0.0013, respectively). ROC curve analysis revealed no significant differences in the ability of SUVmax, TLR and TKR to differentiate CDC from ccRCC. Median survival for CDC was 36 months, worse for older patients.
The utilization of F-FDG PET/CT can assist to detect the metastases and provide guidance for diagnosis and staging. Metabolic parameters obtained from F-FDG PET/CT hold promise for distinguishing CDC from ccRCC.
本研究旨在探讨F-FDG PET/CT在鉴别集合管癌（CDC）与透明细胞肾细胞癌（ccRCC）方面的诊断性能。
对11例接受F-FDG PET/CT检查的CDC患者和27例ccRCC患者进行回顾性分析。记录并比较两组患者的临床指标以及基于基线PET扫描的原发肿瘤的SUVmax、肿瘤与肝脏标准化摄取值比值（TLR）、肿瘤与肾脏标准化摄取值比值（TKR）、代谢肿瘤体积（MTV）和总病灶糖酵解（TLG）值、全身MTV（WBMTV）和全身TLG（WBTLG）。为评估这些代谢参数在CDC和ccRCC之间的鉴别能力，我们进行了受试者操作特征（ROC）曲线分析。
11例CDC患者的中位年龄为59岁。所有CDC患者均处于晚期（18%为III期，82%为IV期）。与ccRCC患者相比，CDC患者的淋巴结转移率更高（72.7%对22.2%，P = 0.008），远处转移率更高（81.8%对22.2%，P = 0.001）。CDC的原发肿瘤在SUVmax（10.5对4.0，P < 0.001）、TLR（3.9对1.4，P < 0.001）、TKR（4.4对1.5，P < 0.001）、MTV（53.2对9.5，P = 0.021）和TLG（305.7对30.4，P = 0.0069）方面也高于ccRCC。CDC患者的WBMTV和WBTLG也高于ccRCC组（分别为144.1对9.5，P = 0.0013和528.4对30.4，P = 0.0013）。ROC曲线分析显示，SUVmax、TLR和TKR区分CDC与ccRCC的能力无显著差异。CDC的中位生存期为36个月，老年患者情况更差。
F-FDG PET/CT的应用有助于检测转移灶，并为诊断和分期提供指导。从F-FDG PET/CT获得的代谢参数有望区分CDC与ccRCC。
