Abstract:
Objective To evaluate the performance of PSMA-targeted 18F-DCFPyL PET/CT in the diagnosis of recurrence or metastasis of renal clear cell carcinoma (ccRCC) after nephrectomy.
Methods A retrospective study was performed in 12 patients with renal cell carcinoma after nephrectomy who were suspected of recurrence or metastasis by clinical and other imaging examinations from December 2018 to October 2019 in the department of nuclear medicine in the First Medical Center of Chinese PLA General Hospital. PSMA-targeted 18F-DCFPyL was used to perform an entire PET/CT examination on the patients to determine the location of the lesion. The size of the suspected lesion and the maximum standard uptake value (SUVmax) were measured, and the number of lesions displayed on the CT images were recorded. The definite diagnosis was used to evaluate the diagnostic ability of PSMA-targeted 18F-DCFPyL PET/CT.
Results There were 37 recurrent or metastatic lesions and one postoperative change in the 12 patients. In the 37 recurrent or metastatic lesions, a total of 35 positive uptake lesions were found by PSMA-targeted 18F-DCFPyL PET/CT, all of which were relapsed or metastatic, indicating the sensitivity of 94.5%. CT found 25 lesions, including 1 lesion of postoperative change, with the diagnostic sensitivity of 64.9%. The median SUVmax of 37 lesions was 7.4 (range, 0.8 - 21.7); the median SUVmax of bone and soft tissue lesions were 6.9 (range, 1.8 - 13.9) and 4.5 (range , 0.8 - 21.7), respectively; the SUVmax of two lymph node lesions was 4.5 and 8.3, respectively. There was a positive correlation between the size and the SUVmax in soft tissue recurrent and metastatic lesions (r=0.544, P=0.024).
Conclusion PSMA-targeted 18F-DCFPyL PET/CT has diagnostic value for recurrence or metastasis of renal clear cell carcinoma after nephrectomy.