Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

[18F]FDG PET/CT: Lung Nodule Evaluation in Patients Affected by Renal Cell Carcinoma

Lighea Simona Airò Farulla
,
Laura Lavinia Travaini
ORCID logo ,
Mariarosaria Cuomo
,
Domenico Galetta
ORCID logo ,
Francesco Mattana
,
Samuele Frassoni
ORCID logo ,
Giuseppe Buonsanti
,
Lorenzo Muraglia
ORCID logo ,
Giulia Anna Zuccotti
,
Vincenzo Bagnardi
,
Lorenzo Spaggiari
,
Francesco Ceci
* ORCID logo
Version 1 : Received: 2 January 2023 / Approved: 4 January 2023 / Online: 4 January 2023 (03:37:05 CET)

A peer-reviewed article of this Preprint also exists.

Airò Farulla, L.S.; Travaini, L.L.; Cuomo, M.; Galetta, D.; Mattana, F.; Frassoni, S.; Buonsanti, G.; Muraglia, L.; Zuccotti, G.A.; Bagnardi, V.; Spaggiari, L.; Ceci, F. [18F]FDG PET/CT: Lung Nodule Evaluation in Patients Affected by Renal Cell Carcinoma. Tomography 2023, 9, 387-397. Airò Farulla, L.S.; Travaini, L.L.; Cuomo, M.; Galetta, D.; Mattana, F.; Frassoni, S.; Buonsanti, G.; Muraglia, L.; Zuccotti, G.A.; Bagnardi, V.; Spaggiari, L.; Ceci, F. [18F]FDG PET/CT: Lung Nodule Evaluation in Patients Affected by Renal Cell Carcinoma. Tomography 2023, 9, 387-397.

Abstract

Renal Cell Carcinoma (RCC) is generally represented by low-FDG avidity, and [18F]FDG-PET/CT is not recommended to stage the primary tumor. However, its role to assess metastases is still unclear. The aim of this study was to evaluate the diagnostic accuracy of [18F]FDG-PET/CT to correctly identify RCC lung metastases using histology as standard of truth. Records of 350 patients affected by RCC and with CT evidence of at least one lung nodule, were retrospectively analyzed. Inclusion criteria were: a) histologically proven RCC; b) [18F]FDG-PET/CT performed prior to lung surgery; c) lung surgery with histological analysis of surgical specimens; d) complete follow-up available. A per-lesion analysis was performed, and diagnostic accuracy was reported as sensitivity and specificity, using histology as standard of truth. [18F]FDG-PET/CT semiquantitative parameters (Standardized Uptake Value [SUVmax], Metabolic Tumor Volume [MTV] and Total Lesion Glycolysis [TLG]) were collected for each lesion. Sixty-seven (n=67) patients with a total of 107 lesions were included: lung metastases from RCC were detected in 57/107 of cases, while 50/107 lesions were related to others lung malignancies. Applying a cut-off of SUVmax ≥2, the sensitivity and the specificity of [18F]FDG-PET/CT for detect RCC lung metastases were 33.3% (95% CI: 21.4% - 47.1%) and 26% (95%CI: 14.6% - 40.3%), respectively. The analysis demonstrated sub-optimal diagnostic accuracy of [18F]FDG-PET/CT to discriminate between RCC lung metastases versus other malignancies. However, semiquantitative analysis including also volumetric parameters (MTV and TLG) can support [18F]FDG-PET/CT image interpretation.

Keywords

PET; lung nodule; Renal Cell Carcinoma; RCC; FDG

Subject

Medicine and Pharmacology, Oncology and Oncogenics

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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