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開催概要
開催回
第56回・2018年・横浜
 

腎細胞癌の転移診断におけるPET/CTの有用性について

演題番号 : P34-4

[筆頭演者]
演者)那須 良次:1 
[共同演者]
田中 大介:1

1:岡山労災病院

 

Objective: 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) have showed promise of restaging and postoperative monitoring in patients with renal cell carcinoma (RCC). We evaluated the efficacy of PET/CT for the detection of distant metastases in patients with RCC.
Material and Methods: A total of 7 patients with metastatic RCC were enrolled on this study (67-81 y.o.). All patients were underwent nephrectomy and postoperative pathological examination revealed clear cell RCC. Metastatic lesions were suspected at median 11 years 8 months (range; 1 year 6 months to 18 years 3 months) after the operation. CT showed 13 abnormal lesions (lung 4, lymph node 3, adrenal 2, pancreas 1, stomach 1, pleura 1, retroperitoneum 1). PET/CT and contrast-enhanced CT were performed. The positive metastatic lesions on PET/CT were diagnosed by low or high grade of FDG avidity of abnormal lesions. When contrast-enhanced CT showed hypervascular mass typical for clear cell RCC, abnormal lesions were diagnosed of positive metastases of clear cell RCC.
Results: PET/CT showed low grade of FDG avidity in 4 lesions and negative uptake in 9 lesions. Seven out of 8 abnormal lesions, contrast-enhanced CT showed hypervascular lesions which were diagnosed metastases of clear cell RCC. The sensitivity of contract-enhanced CT for the detection of metastases was higher than that of PET/CT.
Conclusions: All of distant metastatic lesions of clear cell RCC showed negative or low grade of FDG avidity on PET/CT. The majority of clear cell RCC has high activity of glucose-6-phosphatase. Glucose-6-phosphatase returns FDG-6-phosphate to FDG. FDG is taken out by glucose transporter outside the cell. So the clear cell RCC shows lower grade of FDG avidity than other cancer cells. The potential value of PET/CT for detection of metastases is thought to be low in patients with clear cell RCC.

キーワード

臓器別:腎・尿路・膀胱

手法別:診断

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