Diagnostic performance of 11C-choline PET/CT and FDG PET/CT for staging and restaging of renal cell cancer.
PURPOSE
To compare findings obtained with 11C-choline and FDG PET/CT scanning for renal cell carcinoma staging and restaging.


MATERIALS AND METHODS
Twenty-eight renal cell carcinoma patients whose histological subtype was clear cell type in 26 and papillary type in 2, while Fuhrman nuclear grade was G1,2 in 16 and G3,4 in 12, underwent both 11C-choline and FDG PET/CT examinations before (n = 10) and/or after (n = 18) treatment, then those scanning modalities were compared in regard to patient- and lesion-based diagnostic performance using 5 grading scores. Final diagnosis in each case was obtained based on histopathology, conventional radiological imaging, and clinical follow-up findings. The differences between 11C-choline and FDG PET/CT findings were evaluated using receiver-operating-characteristic (ROC) analysis and a McNemar test.


RESULTS
Patient-based sensitivity, specificity, positive predictive, negative predictive, accuracy, and area under the ROC curve (AUC) values for 11C-choline PET/CT for staging and restaging were 88.0% (22/25), 66.7% (2/3), 95.7% (22/23), 40.0% (2/5), 85.7% (24/28), and 0.887, respectively, while those for FDG-PET/CT were 56.0% (14/25), 66.7% (2/3), 93.3% (14/15), 15.4% (2/13), 57.1% (16/28), and 0.647, respectively. Sensitivity, accuracy, and AUC were significantly different (p = 0.013, p = 0.013, p = 0.012, respectively). Among the 120 lesions, those with kidney, lung, lymph node, bone, pancreas, venous tumor thrombosis, adrenal gland, liver, or skin localization numbered 15, 64, 16, 13, 4, 3, 2, 2, and 1, respectively. For all 120 lesions, 75 (62.5%) and 47 (39.2%) were detected by 11C-choline and FDG PET/CT, respectively (p < 0.0001).


CONCLUSION
For staging and restaging of renal cell carcinoma patients, 11C-choline-PET/CT is significantly more useful than FDG-PET/CT.
['Nakanishi|Yukako|Y|', 'Kitajima|Kazuhiro|K|', 'Yamada|Yusuke|Y|', 'Hashimoto|Takahiko|T|', 'Suzuki|Toru|T|', 'Go|Shuken|S|', 'Kanematsu|Akihiro|A|', 'Nojima|Michio|M|', 'Yamakado|Koichiro|K|', 'Yamamoto|Shingo|S|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D002250:Carbon Radioisotopes D002292:Carcinoma, Renal Cell D002794:Choline D005260:Female D019788:Fluorodeoxyglucose F18 D006801:Humans D008875:Middle Aged D009367:Neoplasm Staging D000072078:Positron Emission Tomography Computed Tomography D012372:ROC Curve
PET FDG Renal cell carcinoma Choline