Journal
CLINICAL NUCLEAR MEDICINE
Volume 40, Issue 12, Pages 936-940Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/RLU.0000000000000875
Keywords
F-18-FDG PET; CT; renal cell carcinoma; pathological nuclear grade
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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-18-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.
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