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European Journal of Nuclear Medicine and Molecular Imaging
Erschienen in:

08.07.2020 | Original Article

The role of 18F-FAZA PET/CT in detecting lymph node metastases in renal cell carcinoma patients: a prospective pilot trial

verfasst von: Umberto Capitanio, Gino Pepe, Elena Incerti, Alessandro Larcher, Francesco Trevisani, Roberta Lucianò, Paola Mapelli, Valentino Bettinardi, Cristina Monterisi, Andrea Necchi, Stefano Cascinu, Rosa Bernardi, Roberto Bertini, Claudio Doglioni, Luigi Gianolli, Andrea Salonia, Maria Picchio, Francesco Montorsi

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 2/2021

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Abstract

Background

The accurate detection of nodal invasion is an unmet need in the clinical staging of renal cancer. Positron emission tomography (PET) with 18F-fluoroazomycin arabinoside (18F-FAZA), a hypoxia specific tracer, is a non-invasive imaging method that detects tumour hypoxia. The aim of this work was to evaluate the role of 18F-FAZA PET/CT in the identification of lymph node metastases in renal cancer.

Methods

A proof-of-concept phase 2 study including 20 kidney cancer patients (ClinicalTrials.​gov Identifier: NCT03955393) was conducted. Inclusion criteria were one or more of the following three criteria: (1) clinical tumour size > 10 cm, (2) evidence of clinical lymphadenopathies at preoperative CT scan and (3) clinical T4 cancer. Before surgery, 18F-FAZA PET/CT was performed, 2 h after the intravenous injection of the radiotracer. An experienced nuclear medicine physician, aware of patient’s history and of all available diagnostic imaging, performed a qualitative and semi-quantitative analysis on 18F-FAZA images. Histopathological analysis was obtained in all patients on surgical specimen.

Results

Fourteen/19 (74%) patients had a non-organ confined renal cell carcinoma (RCC) at final pathology (either pT3 or pT4). Median number of nodes removed was 12 (IQR 7–15). The rate of lymph node invasion was 16%. No patient with pN1 disease showed positive 18F-FAZA PET, thus suggesting the non-hypoxic behaviour of the lesions. In addition, neither primary tumour nor distant metastases presented a pathological 18F-FAZA uptake. No adverse events were recorded during the study.

Conclusions

18F-FAZA PET/CT scan did not detect RCC lymph neither nodal nor distant metastases and did not show any uptake in the primary renal tumour.
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Metadaten
Titel
The role of 18F-FAZA PET/CT in detecting lymph node metastases in renal cell carcinoma patients: a prospective pilot trial
verfasst von
Umberto Capitanio
Gino Pepe
Elena Incerti
Alessandro Larcher
Francesco Trevisani
Roberta Lucianò
Paola Mapelli
Valentino Bettinardi
Cristina Monterisi
Andrea Necchi
Stefano Cascinu
Rosa Bernardi
Roberto Bertini
Claudio Doglioni
Luigi Gianolli
Andrea Salonia
Maria Picchio
Francesco Montorsi
Publikationsdatum
08.07.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 2/2021
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-020-04936-2

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