Research ArticleOncology

A Microdosing Study with 99mTc-PHC-102 for the SPECT/CT Imaging of Primary and Metastatic Lesions in Renal Cell Carcinoma Patients

Oana C. Kulterer, Sarah Pfaff, Wolfgang Wadsak, Nathalie Garstka, Mesut Remzi, Chrysoula Vraka, Lukas Nics, Markus Mitterhauser, Franziska Bootz, Samuele Cazzamalli, Nikolaus Krall, Dario Neri and Alexander R. Haug
Journal of Nuclear Medicine March 2021, 62 (3) 360-365; DOI: https://doi.org/10.2967/jnumed.120.245530

Article Figures & Data

Figures

  • FIGURE 1.
    FIGURE 1.

    99mTc-PHC-102 blood levels. Blood clearance profiles were assessed by collecting blood samples at different time points and counting corresponding radioactivity values. Curve was calculated as average of values derived from individual patients. Variations in clearance rate were observed, possibly reflecting differences in kidney function.

  • FIGURE 2.
    FIGURE 2.

    Anterior whole-body planar (A) and transverse SPECT (B) and 99mTc-PHC-102 fused SPECT/CT (C) images in 80-y-old patient with ccRCC (CAIX-positive). High uptake of radiotracer (arrows) in primary tumor (7.2 cm, upper pole of left kidney), in stomach, and in gallbladder was observed. Additional metastatic lesion (2.3 × 1.6 cm) in lung was also detected at all time points (0.5, 2, and 6 h).

  • FIGURE 3.
    FIGURE 3.

    Anterior SPECT/CT (A) and SPECT (B) scans obtained with 99mTc-PHC-102 in 49-y-old patient at (from left to right) 30 min, 2 h, and 6 h after administration of tracer. Primary neoplastic lesion (arrows) protruding from cortex of right kidney (1.6 cm) is visible at all time points. Renal excretion is appreciable from high signal observed in bladder at 30-min time point and from kidney uptake.

  • FIGURE 4.
    FIGURE 4.

    Anterior SPECT (arrows indicate RCC and metastases) (A) and transverse SPECT/CT (B) scans obtained with 99mTc-PHC-102 in 80-y-old patient at 6-h time point. Primary large tumor mass (A and B) in right kidney (7.2 cm), arrow in B indicates RCC) was detectable because of high tracer uptake. Tumor thrombus in vena cava (B and C); indicated with an arrow in C), as well as metastatic lesions in lymph node (D) indicated with an arrow) and in lung (E), indicated with an arrow), were also visible 6 h after 99mTc-PHC-102 injection because of high tracer uptake.

Tables

  • TABLE 1

    Demographic Parameters and Histologic Information

    SubjectAge (y)SexDisease duration (y)Histology–CAIX
    180M<2Positive
    268M<2Positive
    380M<2Positive
    449M<2Negative
    532M<2Unknown
  • TABLE 2

    99mTc-PHC-102 SUVs Corresponding to Different Time Points

    SUVmaxSUVmean
    Organ30 min2 h6 h30 min2 h6 h
    Tumor20.14 ± 3.9418.43 ± 5.1515.48 ± 4.7414.02 ± 3.3211.7 ± 3.0810.38 ± 2.07
    Kidney35.04 ± 6.5026.6 ± 4.0517.50 ± 2.1919.68 ± 4.4916.75 ± 1.7512.24 ± 1.33
    Liver4.26 ± 1.135.43 ± 1.116.06 ± 3.083.1 ± 1.164.00 ± 1.144.54 ± 2.57
    Gallbladder9.23 ± 3.6617.2 ± 6.5828.58 ± 11.806.55 ± 2.4810.65 ± 2.7715.28 ± 3.99
    Intestine6.78 ± 1.0311.3 ± 4.5710.80 ± 3.393.44 ± 1.123.65 ± 0.603.04 ± 0.93
    Lung0.94 ± 0.320.85 ± 0.300.56 ± 0.260.58 ± 0.260.40 ± 0.270.22 ± 0.13
    Brain0.32 ± 0.150.375 ± 0.220.28 ± 0.170.12 ± 0.120.11 ± 0.130.06 ± 0.05
    Stomach47.68 ± 15.6358.5 ± 16.4249.18 ± 28.5421.22 ± 5.9324.88 ± 6.1220.96 ± 8.14
    Spleen1.28 ± 0.290.925 ± 0.340.78 ± 0.130.62 ± 0.260.35 ± 0.210.22 ± 0.08
    Salivary gland3.02 ± 2.521.32 ± 2.381.60 ± 0.942.3 ± 1.691.83 ± 1.311.08 ± 0.64

    • Average SUVmax and SUVmean are based on individual values from 5 patients imaged with microdosing 99mTc-PHC-102 SPECT/CT.

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