Objectives To investigate the differences fluorodeoxyglucose (FDG) dynamics between clear cell renal cell carcinoma (ccRCC) and non-ccRCC as a potential diagnostic clue, using dynamic whole-body (D-WB) and dual-time-point (DTP) FDG-PET/computed tomography (CT) imaging. Patients and methods D-WB and DTP FDG-PET/CT scans were performed for 26 RCC patients. We obtained Pearson’s correlation coefficients between the static maximum standardized uptake value (SUV max ) and tumor size and dynamic metabolic rate (MR FDG ) and distribution volume of FDG (DV FDG ) parameters. We compared MR FDG and DV FDG by tumor type and performed receiver operating characteristic (ROC) analyses for each parameter. Results Nineteen ccRCC and nine non-ccRCC lesions including molecularly defined carcinomas were analyzed. Compared with the ccRCC ( r = 0.55–0.81), the MR FDG in the non-ccRCC was more strongly correlated with the early (SUVe) and delayed (SUVd) SUV max and tumor size ( r = 0.72–0.97). The DV FDG in the non-ccRCC was more strongly correlated with SUVe and SUVd ( r = 0.93, 0.84) vs. the ccRCC ( r = 0.55, 0.66). SUVe and SUVd were significantly higher in the non-ccRCC vs. ccRCC (analyses for all or T3/4 RCC, both P < 0.05). MR FDG was significantly higher in the T3/4 non-ccRCC vs. the T3/4 ccRCC ( P = 0.04). In the ROC analysis for differentiating ccRCC and non-ccRCC, SUVd showed the highest area under the curve (0.92–0.93 for all and T3/4 RCC) than other parameters (0.70–0.84). Conclusion D-WB FDG-PET/CT imaging clearly demonstrated different FDG dynamics between ccRCC and non-ccRCC. Non-ccRCC showed higher MR FDG values than ccRCC, but dynamic images have a limited role in differentiating these lesions. SUVd could be the most suitable parameter for differentiating ccRCC and non-ccRCC.
Kaneko et al. (Tue,) studied this question.
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