carbon-11-acetate and Kidney-Neoplasms

The recent identification of agents that have significantly influenced the therapy of clear cell renal carcinoma and the decreasing size of renal masses, usually detected serendipitously, have led to a resurgence in imaging for this condition. Although structural methods continue to be used routinely for identification of renal masses, functional and molecular techniques are showing considerable promise in their ability to characterize unique features of the renal cancer phenotype. This article discusses the evolving role of molecular imaging in the evaluation of renal cancer, including current and future applications.

Topics: Acetates; Antibodies, Monoclonal; Antigens, Neoplasm; Carbon; Carcinoma, Renal Cell; Fluorodeoxyglucose F18; Genetic Markers; Humans; Iodine Radioisotopes; Kidney Neoplasms; Molecular Probe Techniques; Positron-Emission Tomography; Radioactive Tracers

The study aims to assess the usefulness of PET with C-acetate and F-FDG to differentiate renal cell carcinoma (RCC) from complicated renal cysts.. Thirty-one patients were enrolled, 14 patients with complicated renal cysts (12 with Bosniak III and 2 with Bosniak IV) and 17 patients with 19 solid renal tumors. The patients underwent both C-acetate PET and FDG PET. Nephrectomy or partial nephrectomy was performed after the PET scans.. In 29 patients, 32 renal lesions were diagnosed as RCC. Twenty-three of the 32 RCCs (72%) had positive C-acetate PET findings, whereas only 7 FDG PET studies were positive (22%). Considering the relationship between tumor size measured by macroscopic appearance of resected tumors and PET results, 22 of 25 (88%) tumors more than 1.5 cm showed positive C-acetate PET findings. In 12 patients with Bosniak III renal cysts, 10 renal lesions were diagnosed as RCC. In this subgroup, 5 of the 10 RCCs (50%) had positive C-acetate PET findings, whereas 2 RCCs (20%) had positive FDG PET findings. None of the cases with benign findings had positive C-acetate PET or FDG PET scans.. C-acetate PET demonstrates a pronounced increase in tracer uptake in RCC, especially in renal tumors more than 1.5 cm, and displays a higher sensitivity than FDG PET. These preliminary data show that C-acetate may be a useful PET tracer to exclude RCC in complex renal cysts.

Topics: Acetates; Adult; Aged; Aged, 80 and over; Carbon; Fluorodeoxyglucose F18; Humans; Kidney Neoplasms; Middle Aged; Positron-Emission Tomography; Tumor Burden