18Fluorodeoxyglucose-positron emission tomography/computed tomography for differentiation of renal tumors in hereditary kidney cancer syndromes

Moozhan Nikpanah; Anna K. Paschall; Mark A. Ahlman; Ali Cahid Civelek; Faraz Farhadi; S. Mojdeh Mirmomen; Xiaobai Li; Babak Saboury; Mark W. Ball; Maria J. Merino; Ramaprasad Srinivasan; Elizabeth C. Jones; W. Marston Linehan; Ashkan A. Malayeri

doi:10.1007/s00261-021-02999-9

¹⁸Fluorodeoxyglucose-positron emission tomography/computed tomography for differentiation of renal tumors in hereditary kidney cancer syndromes

Moozhan Nikpanah, Anna K. Paschall, Mark A. Ahlman, Ali Cahid Civelek, Faraz Farhadi, S. Mojdeh Mirmomen, Xiaobai Li, Babak Saboury, Mark W. Ball, Maria J. Merino, Ramaprasad Srinivasan, Elizabeth C. Jones, W. Marston Linehan, Ashkan A. Malayeri

Research output: Contribution to journal › Article › peer-review

2 Scopus citations

Abstract

Purpose: To assess differences in FDG-PET/CT uptake among four subtypes of renal tumors: clear cell RCC (ccRCC), papillary type I and II RCC (pRCC), and oncocytoma. Methods: This retrospective study investigated 33 patients with 98 hereditary renal tumors. Lesions greater than 1 cm and patients with a timeframe of less than 18 months between preoperative imaging and surgery were considered. FDG-PET/CT images were independently reviewed by two nuclear medicine physicians, blinded to clinical information. Volumetric lesion SUV_mean was measured and used to calculate a target-to-background ratio respective to liver (TBR). The Shrout-Fleiss intra-class correlation coefficient was used to assess reliability between readers. A linear mixed effects model, accounting for within-patient correlations, was used to compare TBR values of primary renal lesions with and without distant metastasis. Results: The time interval between imaging and surgery for all tumors had a median of 77 (Mean: 139; Range: 1–512) days. Intra-class reliability of mean TBR resulted in a mean κ score of 0.93, indicating strong agreement between the readers. The mixed model showed a significant difference in mean TBR among the subtypes (p < 0.0001). Pairwise comparison showed significant differences between pRCC type II and ccRCC (p < 0.0001), pRCC type II and pRCC type I (p = 0.0001), and pRCC type II and oncocytoma (p = 0.0016). Furthermore, a significant difference in FDG uptake was present between primary pRCC type II renal lesions with and without distant metastasis (p = 0.023). Conclusion: pRCC type II lesions demonstrated significantly higher FDG activity than ccRCC, pRCC type I, or oncocytoma. These findings indicate that FDG may prove useful in studying the metabolic activity of renal neoplasms, identifying lesions of highest clinical concern, and ultimately optimizing active surveillance, and personalizing management plans.

Original language	English (US)
Pages (from-to)	3301-3308
Number of pages	8
Journal	Abdominal Radiology
Volume	46
Issue number	7
DOIs	https://doi.org/10.1007/s00261-021-02999-9
State	Published - Jul 2021
Externally published	Yes

Keywords

FDG-PET/CT
Hereditary Kidney Cancer Syndromes
Renal tumors
Subtype differentiation

ASJC Scopus subject areas

Radiological and Ultrasound Technology
Radiology Nuclear Medicine and imaging
Gastroenterology
Urology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1007/s00261-021-02999-9

Cite this

Nikpanah, M., Paschall, A. K., Ahlman, M. A., Civelek, A. C., Farhadi, F., Mirmomen, S. M., Li, X., Saboury, B., Ball, M. W., Merino, M. J., Srinivasan, R., Jones, E. C., Linehan, W. M., & Malayeri, A. A. (2021). ¹⁸Fluorodeoxyglucose-positron emission tomography/computed tomography for differentiation of renal tumors in hereditary kidney cancer syndromes. Abdominal Radiology, 46(7), 3301-3308. https://doi.org/10.1007/s00261-021-02999-9

Nikpanah, M, Paschall, AK, Ahlman, MA, Civelek, AC, Farhadi, F, Mirmomen, SM, Li, X, Saboury, B, Ball, MW, Merino, MJ, Srinivasan, R, Jones, EC, Linehan, WM & Malayeri, AA 2021, '¹⁸Fluorodeoxyglucose-positron emission tomography/computed tomography for differentiation of renal tumors in hereditary kidney cancer syndromes', Abdominal Radiology, vol. 46, no. 7, pp. 3301-3308. https://doi.org/10.1007/s00261-021-02999-9

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title = "18Fluorodeoxyglucose-positron emission tomography/computed tomography for differentiation of renal tumors in hereditary kidney cancer syndromes",

abstract = "Purpose: To assess differences in FDG-PET/CT uptake among four subtypes of renal tumors: clear cell RCC (ccRCC), papillary type I and II RCC (pRCC), and oncocytoma. Methods: This retrospective study investigated 33 patients with 98 hereditary renal tumors. Lesions greater than 1 cm and patients with a timeframe of less than 18 months between preoperative imaging and surgery were considered. FDG-PET/CT images were independently reviewed by two nuclear medicine physicians, blinded to clinical information. Volumetric lesion SUVmean was measured and used to calculate a target-to-background ratio respective to liver (TBR). The Shrout-Fleiss intra-class correlation coefficient was used to assess reliability between readers. A linear mixed effects model, accounting for within-patient correlations, was used to compare TBR values of primary renal lesions with and without distant metastasis. Results: The time interval between imaging and surgery for all tumors had a median of 77 (Mean: 139; Range: 1–512) days. Intra-class reliability of mean TBR resulted in a mean κ score of 0.93, indicating strong agreement between the readers. The mixed model showed a significant difference in mean TBR among the subtypes (p < 0.0001). Pairwise comparison showed significant differences between pRCC type II and ccRCC (p < 0.0001), pRCC type II and pRCC type I (p = 0.0001), and pRCC type II and oncocytoma (p = 0.0016). Furthermore, a significant difference in FDG uptake was present between primary pRCC type II renal lesions with and without distant metastasis (p = 0.023). Conclusion: pRCC type II lesions demonstrated significantly higher FDG activity than ccRCC, pRCC type I, or oncocytoma. These findings indicate that FDG may prove useful in studying the metabolic activity of renal neoplasms, identifying lesions of highest clinical concern, and ultimately optimizing active surveillance, and personalizing management plans.",

keywords = "FDG-PET/CT, Hereditary Kidney Cancer Syndromes, Renal tumors, Subtype differentiation",

author = "Moozhan Nikpanah and Paschall, {Anna K.} and Ahlman, {Mark A.} and Civelek, {Ali Cahid} and Faraz Farhadi and Mirmomen, {S. Mojdeh} and Xiaobai Li and Babak Saboury and Ball, {Mark W.} and Merino, {Maria J.} and Ramaprasad Srinivasan and Jones, {Elizabeth C.} and Linehan, {W. Marston} and Malayeri, {Ashkan A.}",

note = "Publisher Copyright: {\textcopyright} 2021, This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply.",

year = "2021",

month = jul,

doi = "10.1007/s00261-021-02999-9",

language = "English (US)",

volume = "46",

pages = "3301--3308",

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TY - JOUR

T1 - 18Fluorodeoxyglucose-positron emission tomography/computed tomography for differentiation of renal tumors in hereditary kidney cancer syndromes

AU - Nikpanah, Moozhan

AU - Paschall, Anna K.

AU - Ahlman, Mark A.

AU - Civelek, Ali Cahid

AU - Farhadi, Faraz

AU - Mirmomen, S. Mojdeh

AU - Li, Xiaobai

AU - Saboury, Babak

AU - Ball, Mark W.

AU - Merino, Maria J.

AU - Srinivasan, Ramaprasad

AU - Jones, Elizabeth C.

AU - Linehan, W. Marston

AU - Malayeri, Ashkan A.

PY - 2021/7

Y1 - 2021/7

N2 - Purpose: To assess differences in FDG-PET/CT uptake among four subtypes of renal tumors: clear cell RCC (ccRCC), papillary type I and II RCC (pRCC), and oncocytoma. Methods: This retrospective study investigated 33 patients with 98 hereditary renal tumors. Lesions greater than 1 cm and patients with a timeframe of less than 18 months between preoperative imaging and surgery were considered. FDG-PET/CT images were independently reviewed by two nuclear medicine physicians, blinded to clinical information. Volumetric lesion SUVmean was measured and used to calculate a target-to-background ratio respective to liver (TBR). The Shrout-Fleiss intra-class correlation coefficient was used to assess reliability between readers. A linear mixed effects model, accounting for within-patient correlations, was used to compare TBR values of primary renal lesions with and without distant metastasis. Results: The time interval between imaging and surgery for all tumors had a median of 77 (Mean: 139; Range: 1–512) days. Intra-class reliability of mean TBR resulted in a mean κ score of 0.93, indicating strong agreement between the readers. The mixed model showed a significant difference in mean TBR among the subtypes (p < 0.0001). Pairwise comparison showed significant differences between pRCC type II and ccRCC (p < 0.0001), pRCC type II and pRCC type I (p = 0.0001), and pRCC type II and oncocytoma (p = 0.0016). Furthermore, a significant difference in FDG uptake was present between primary pRCC type II renal lesions with and without distant metastasis (p = 0.023). Conclusion: pRCC type II lesions demonstrated significantly higher FDG activity than ccRCC, pRCC type I, or oncocytoma. These findings indicate that FDG may prove useful in studying the metabolic activity of renal neoplasms, identifying lesions of highest clinical concern, and ultimately optimizing active surveillance, and personalizing management plans.

AB - Purpose: To assess differences in FDG-PET/CT uptake among four subtypes of renal tumors: clear cell RCC (ccRCC), papillary type I and II RCC (pRCC), and oncocytoma. Methods: This retrospective study investigated 33 patients with 98 hereditary renal tumors. Lesions greater than 1 cm and patients with a timeframe of less than 18 months between preoperative imaging and surgery were considered. FDG-PET/CT images were independently reviewed by two nuclear medicine physicians, blinded to clinical information. Volumetric lesion SUVmean was measured and used to calculate a target-to-background ratio respective to liver (TBR). The Shrout-Fleiss intra-class correlation coefficient was used to assess reliability between readers. A linear mixed effects model, accounting for within-patient correlations, was used to compare TBR values of primary renal lesions with and without distant metastasis. Results: The time interval between imaging and surgery for all tumors had a median of 77 (Mean: 139; Range: 1–512) days. Intra-class reliability of mean TBR resulted in a mean κ score of 0.93, indicating strong agreement between the readers. The mixed model showed a significant difference in mean TBR among the subtypes (p < 0.0001). Pairwise comparison showed significant differences between pRCC type II and ccRCC (p < 0.0001), pRCC type II and pRCC type I (p = 0.0001), and pRCC type II and oncocytoma (p = 0.0016). Furthermore, a significant difference in FDG uptake was present between primary pRCC type II renal lesions with and without distant metastasis (p = 0.023). Conclusion: pRCC type II lesions demonstrated significantly higher FDG activity than ccRCC, pRCC type I, or oncocytoma. These findings indicate that FDG may prove useful in studying the metabolic activity of renal neoplasms, identifying lesions of highest clinical concern, and ultimately optimizing active surveillance, and personalizing management plans.

KW - FDG-PET/CT

KW - Hereditary Kidney Cancer Syndromes

KW - Renal tumors

KW - Subtype differentiation

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