Lesion Detection by [Zr]Zr-DFO-girentuximab and [F]FDG-PET/CT in Patients with Newly Diagnosed Metastatic Renal Cell Carcinoma

Overview

Journal Eur J Nucl Med Mol Imaging

Specialties Biophysics
Nuclear Medicine
Radiology

Date 2019 Jun 8

PMID 31172212

Citations 36

Authors

Sarah R Verhoeff

Suzanne C van Es

Eline Boon

Erik van Helden

Lindsay Angus

Sjoerd G Elias

Sjoukje F Oosting

Erik H Aarntzen

Adrienne H Brouwers

Thomas C Kwee

Sandra Heskamp

Otto S Hoekstra

Henk Verheul

Astrid A M van der Veldt

Elisabeth G E de Vries

Otto C Boerman

Winette T A van der Graaf

Wim J G Oyen

Carla M L Van Herpen

Affiliations

Soon will be listed here.

Abstract

Purpose: The main objective of this preliminary analysis of the IMaging PAtients for Cancer drug selecTion (IMPACT)-renal cell cancer (RCC) study is to evaluate the lesion detection of baseline contrast-enhanced CT, [Zr]Zr-DFO-girentuximab-PET/CT and [F]FDG-PET/CT in detecting ccRCC lesions in patients with a good or intermediate prognosis metastatic clear cell renal cell carcinoma (mccRCC) according to the International Metastatic Database Consortium (IMDC) risk model.

Methods: Between February 2015 and March 2018, 42 newly diagnosed mccRCC patients with good or intermediate prognosis, eligible for watchful waiting, were included. Patients underwent CT, [Zr]Zr-DFO-girentuximab-PET/CT and [F]FDG-PET/CT at baseline. Scans were independently reviewed and lesions of ≥10 mm and lymph nodes of ≥15 mm at CT were analyzed. For lesions with [Zr]Zr-DFO-girentuximab or [F]FDG-uptake visually exceeding background uptake, maximum standardized uptake values (SUV) were measured.

Results: A total of 449 lesions were detected by ≥1 modality (median per patient: 7; ICR 4.25-12.75) of which 42% were in lung, 22% in lymph nodes and 10% in bone. Combined [Zr]Zr-DFO-girentuximab-PET/CT and CT detected more lesions than CT alone: 91% (95%CI: 87-94) versus 56% (95%CI: 50-62, p = 0.001), respectively, and more than CT and [F]FDG-PET/CT combined (84% (95%CI:79-88, p < 0.005). Both PET/CTs detected more bone and soft tissue lesions compared to CT alone.

Conclusions: The addition of [Zr]Zr-DFO-girentuximab-PET/CT and [F]FDG-PET/CT to CT increases lesion detection compared to CT alone in newly diagnosed good and intermediate prognosis mccRCC patients eligible for watchful waiting.

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