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Eur J Nucl Med Mol Imaging. 2019 Aug;46(9):1931-1939. doi: 10.1007/s00259-019-04358-9. Epub 2019 Jun 6.

Lesion detection by [89Zr]Zr-DFO-girentuximab and [18F]FDG-PET/CT in patients with newly diagnosed metastatic renal cell carcinoma.

Author information

1
Department of Medical Oncology, Radboud University Medical Center Nijmegen, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
2
Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
3
Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam, The Netherlands.
4
Departments of Medical Oncology and Radiology & Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.
5
Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
6
Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
7
Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
8
Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
9
Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands.
10
Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands.
11
Department of Radiology and Nuclear Medicine, Rijnstate, Arnhem, The Netherlands.
12
Department of Biomedical Sciences, Humanitas University, Milan, Italy.
13
Department of Medical Oncology, Radboud University Medical Center Nijmegen, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands. Carla.vanherpen@radboudumc.nl.

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, [89Zr]Zr-DFO-girentuximab-PET/CT and [18F]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, [89Zr]Zr-DFO-girentuximab-PET/CT and [18F]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 [89Zr]Zr-DFO-girentuximab or [18F]FDG-uptake visually exceeding background uptake, maximum standardized uptake values (SUVmax) 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 [89Zr]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 [18F]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 [89Zr]Zr-DFO-girentuximab-PET/CT and [18F]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.

KEYWORDS:

CAIX; Clear cell renal cell carcinoma; FDG; Girentuximab; Imaging; PET

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