F18-FDG PET-CT for the postoperative surveillance of advanced renal cell carcinoma

Objectives Present study was aimed to evaluate the role of F18-fluorodeoxyglucose (FDG) positron-emission tomography/computed tomography (PET/CT) for the surveillance of patients with advanced renal cell carcinoma (RCC) for detection of local recurrence or distant metastasis.

Methods Forty-two patients with advanced RCC had conventional imaging studies and FDG PET-CT during the follow-up after surgical treatment. There were 38 males and 4 females with mean age of 56 years ranging from 22 to 75 years. Total 48 PET-CT studies were conducted on these 42 patients with 3 patients having undergone scanning thrice. Suspicious recurrent or metastatic lesions were confirmed by histopathology or by clinical follow-up. The sensitivity, specificity, and accuracy of FDG PET-CT were analyzed.

Results Of 42 patients, 25 had left sided RCC, 15 had right sided RCC and only 2 of them had bilateral disease. Out of total 48 studies, 13 were normal and 35 studies were abnormal. These normal 13 studies were in 13 patients. Twenty-nine patients had 35 abnormal studies, in which, 17 had lesions in lung, 12 patients had renal bed recurrence, 11 had bone metastatic disease, 6 patients had retroperitoneal lymph node involvement, 4 of them had mediastinal lymph node involvement, 2 had liver lesions, 2 had contralateral kidney involvement and adrenal gland and lateral abdominal wall metastasis was present in 1 patient. FDG PET/CT had sensitivity of 97%, specificity of 93%, and accuracy of 96% in detecting recurrence or metastasis in detecting recurrence in patients with RCC.

Conclusions FDG PET/CT was found to have high diagnostic value for detection of local recurrence or distant metastasis in patients with advanced renal cell carcinoma. In addition, it was possible to examine whole body in one procedure