Positron Emission Tomography/computed Tomography Identification of Clear Cell Renal Cell Carcinoma: Results from the REDECT Trial

Overview

Journal J Clin Oncol

Specialty Oncology

Date 2012 Dec 6

PMID 23213092

Citations 89

Authors

Chaitanya R Divgi

Robert G Uzzo

Constantine Gatsonis

Roman Bartz

Silke Treutner

Jian Qin Yu

David Chen

Jorge A Carrasquillo

Steven Larson

Paul Bevan

Paul Russo

Affiliations

Soon will be listed here.

Abstract

Purpose: A clinical study to characterize renal masses with positron emission tomography/computed tomography (PET/CT) was undertaken.

Patients And Methods: This was an open-label multicenter study of iodine-124 ((124)I) -girentuximab PET/CT in patients with renal masses who were scheduled for resection. PET/CT and contrast-enhanced CT (CECT) of the abdomen were performed 2 to 6 days after intravenous (124)I-girentuximab administration and before resection of the renal mass(es). Images were interpreted centrally by three blinded readers for each imaging modality. Tumor histology was determined by a blinded central pathologist. The primary end points-average sensitivity and specificity for clear cell renal cell carcinoma (ccRCC)-were compared between the two modalities. Agreement between and within readers was assessed.

Results: (124)I-girentuximab was well tolerated. In all, 195 patients had complete data sets (histopathologic diagnosis and PET/CT and CECT results) available. The average sensitivity was 86.2% (95% CI, 75.3% to 97.1%) for PET/CT and 75.5% (95% CI, 62.6% to 88.4%) for CECT (P = .023). The average specificity was 85.9% (95% CI, 69.4% to 99.9%) for PET/CT and 46.8% (95% CI, 18.8% to 74.7%) for CECT (P = .005). Inter-reader agreement was high (κ range, 0.87 to 0.92 for PET/CT; 0.67 to 0.76 for CECT), as was intrareader agreement (range, 87% to 100% for PET/CT; 73.7% to 91.3% for CECT).

Conclusion: This study represents (to the best of our knowledge) the first clinical validation of a molecular imaging biomarker for malignancy. (124)I-girentuximab PET/CT can accurately and noninvasively identify ccRCC, with potential utility for designing best management approaches for patients with renal masses.

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References

Weber W . Assessing tumor response to therapy. J Nucl Med. 2009; 50 Suppl 1:1S-10S. DOI: 10.2967/jnumed.108.057174. View

Sorbellini M, Kattan M, Snyder M, Reuter V, Motzer R, Goetzl M . A postoperative prognostic nomogram predicting recurrence for patients with conventional clear cell renal cell carcinoma. J Urol. 2004; 173(1):48-51. DOI: 10.1097/01.ju.0000148261.19532.2c. View

Berland L, Silverman S, Gore R, Mayo-Smith W, Megibow A, Yee J . Managing incidental findings on abdominal CT: white paper of the ACR incidental findings committee. J Am Coll Radiol. 2010; 7(10):754-73. DOI: 10.1016/j.jacr.2010.06.013. View

Cheville J, Lohse C, Zincke H, Weaver A, Blute M . Comparisons of outcome and prognostic features among histologic subtypes of renal cell carcinoma. Am J Surg Pathol. 2003; 27(5):612-24. DOI: 10.1097/00000478-200305000-00005. View

Wood B, Khan M, McGovern F, Harisinghani M, Hahn P, Mueller P . Imaging guided biopsy of renal masses: indications, accuracy and impact on clinical management. J Urol. 1999; 161(5):1470-4. DOI: 10.1016/s0022-5347(05)68929-x. View

Schachter L, Cookson M, Chang S, Smith Jr J, Dietrich M, Jayaram G . Second prize: frequency of benign renal cortical tumors and histologic subtypes based on size in a contemporary series: what to tell our patients. J Endourol. 2007; 21(8):819-23. DOI: 10.1089/end.2006.9937. View

Maturen K, Nghiem H, Caoili E, Higgins E, Wolf Jr J, Wood Jr D . Renal mass core biopsy: accuracy and impact on clinical management. AJR Am J Roentgenol. 2007; 188(2):563-70. DOI: 10.2214/AJR.06.0220. View

Povoski S, Hall N, Murrey Jr D, Sharp D, Hitchcock C, Mojzisik C . Multimodal imaging and detection strategy with 124 I-labeled chimeric monoclonal antibody cG250 for accurate localization and confirmation of extent of disease during laparoscopic and open surgical resection of clear cell renal cell carcinoma. Surg Innov. 2012; 20(1):59-69. PMC: 3758170. DOI: 10.1177/1553350612438416. View

Huang W, Levey A, Serio A, Snyder M, Vickers A, Raj G . Chronic kidney disease after nephrectomy in patients with renal cortical tumours: a retrospective cohort study. Lancet Oncol. 2006; 7(9):735-40. PMC: 2239298. DOI: 10.1016/S1470-2045(06)70803-8. View

10.

Huang W, Elkin E, Levey A, Jang T, Russo P . Partial nephrectomy versus radical nephrectomy in patients with small renal tumors--is there a difference in mortality and cardiovascular outcomes?. J Urol. 2008; 181(1):55-61. PMC: 2748741. DOI: 10.1016/j.juro.2008.09.017. View

11.

Lane B, Samplaski M, Herts B, Zhou M, Novick A, Campbell S . Renal mass biopsy--a renaissance?. J Urol. 2007; 179(1):20-7. DOI: 10.1016/j.juro.2007.08.124. View

12.

Zini L, Perrotte P, Capitanio U, Jeldres C, Shariat S, Antebi E . Radical versus partial nephrectomy: effect on overall and noncancer mortality. Cancer. 2009; 115(7):1465-71. DOI: 10.1002/cncr.24035. View

13.

Siegel R, Ward E, Brawley O, Jemal A . Cancer statistics, 2011: the impact of eliminating socioeconomic and racial disparities on premature cancer deaths. CA Cancer J Clin. 2011; 61(4):212-36. DOI: 10.3322/caac.20121. View

14.

Motzer R, Bacik J, Mariani T, Russo P, Mazumdar M, Reuter V . Treatment outcome and survival associated with metastatic renal cell carcinoma of non-clear-cell histology. J Clin Oncol. 2002; 20(9):2376-81. DOI: 10.1200/JCO.2002.11.123. View

15.

Herts B, Baker M . The current role of percutaneous biopsy in the evaluation of renal masses. Semin Urol Oncol. 1995; 13(4):254-61. View

16.

Leveridge M, Finelli A, Kachura J, Evans A, Chung H, Shiff D . Outcomes of small renal mass needle core biopsy, nondiagnostic percutaneous biopsy, and the role of repeat biopsy. Eur Urol. 2011; 60(3):578-84. DOI: 10.1016/j.eururo.2011.06.021. View

17.

Kim J, Kim T, Ahn H, Kim C, Kim K, Cho K . Differentiation of subtypes of renal cell carcinoma on helical CT scans. AJR Am J Roentgenol. 2002; 178(6):1499-506. DOI: 10.2214/ajr.178.6.1781499. View

18.

Snyder M, Bach A, Kattan M, Raj G, Reuter V, Russo P . Incidence of benign lesions for clinically localized renal masses smaller than 7 cm in radiological diameter: influence of sex. J Urol. 2006; 176(6 Pt 1):2391-5. DOI: 10.1016/j.juro.2006.08.013. View

19.

Linehan W, Walther M, Zbar B . The genetic basis of cancer of the kidney. J Urol. 2003; 170(6 Pt 1):2163-72. DOI: 10.1097/01.ju.0000096060.92397.ed. View

20.

Kutikov A, Fossett L, Ramchandani P, Tomaszewski J, Siegelman E, Banner M . Incidence of benign pathologic findings at partial nephrectomy for solitary renal mass presumed to be renal cell carcinoma on preoperative imaging. Urology. 2006; 68(4):737-40. DOI: 10.1016/j.urology.2006.04.011. View