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.

Mereotopology is a concept rooted in analytical philosophy. The phase-field concept is based on mathematical physics and finds applications in materials engineering. The two concepts seem to be disjoint at a first glance. While mereotopology qualitatively describes static relations between things like x isConnected y (topology) or x isPartOf y (mereology) by first order logic and Boolean algebra, the phase-field concept describes the geometric shape of things and its dynamic evolution by drawing on a scalar field. The geometric shape of any thing is defined by its boundaries to one or more neighboring things. The notion and description of boundaries thus provides a bridge between mereotopology and the phase-field concept. The present article aims to relate phase-field expressions describing boundaries and especially triple junctions to their Boolean counterparts in mereotopology and contact algebra. An introductory overview on mereotopology is followed by an introduction to the phase-field concept already indicating first relations to mereo- topology. Mereotopological axioms and definitions are then discussed in detail from a phase-field perspective. A dedicated section introduces and discusses further notions of the isConnected relation emerging from the phase-field perspective like isSpatiallyConnected, isTemporallyConnected, isPhysicallyConnected, isPathConnected and wasConnected. Such relations introduce dynamics and thus physics into mereotopology as transitions from isDisconnected to isPartOf can be described.