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Utility of 68 Ga prostate specific membrane antigen – positron emission tomography in diagnosis and response assessment of recurrent renal cell carcinoma
Author(s) -
Siva Shankar,
Callahan Jason,
Pryor David,
Martin Jarad,
Lawrentschuk Nathan,
Hofman Michael S
Publication year - 2017
Publication title -
journal of medical imaging and radiation oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.31
H-Index - 43
eISSN - 1754-9485
pISSN - 1754-9477
DOI - 10.1111/1754-9485.12590
Subject(s) - medicine , glutamate carboxypeptidase ii , positron emission tomography , prostate cancer , sabr volatility model , nuclear medicine , radiology , renal cell carcinoma , pet ct , cancer , oncology , volatility (finance) , stochastic volatility , financial economics , economics
Prostate specific membrane antigen ( PSMA ) positron emission tomography ( PET ) is an emerging imaging modality in prostate cancer. However, 68 Ga‐ PSMA ‐ PET may also have diagnostic utility in the setting of renal cell carcinoma ( RCC ). We investigate the differential role of 18 F‐fluorodeoxyglucose ( FDG ) and PSMA ‐ PET / CT scanning in patients with oligometastatic RCC . In particular, we focus on the utility of PSMA ‐ PET for diagnostic evaluation of isolated or limited metastases planned for local surgery or radiation, as well as the potential utility of PSMA ‐ PET for therapeutic response assessment in patients receiving stereotactic ablative body radiotherapy ( SABR ). Methods We present a retrospective series of eight patients in which comparative imaging modalities are evaluated against PSMA ‐ PET scanning. FDG ‐ PET and PSMA ‐ PET scans were performed prior to definitive treatment (either surgery or SABR ) of limited recurrent disease. Response assessment after SABR was performed with both PET imaging modalities at multiple time points in a subset of four patients. Results Prostate specific membrane antigen uptake is typically more intense than FDG in RCC . In all but two cases, one of which was papillary carcinoma, FDG ‐ PET and PSMA ‐ PET are concordant for detection of sites of disease. We demonstrate for the first time the differential kinetics of post‐treatment response using PSMA and FDG ‐ PET , with a more rapid metabolic response observed on FDG ‐ PET . Both modalities demonstrate response earlier than morphological appearances on CT or MRI imaging. Conclusions Our series suggests that PSMA shows early promise as a diagnostic and therapeutic response assessment tool in patients with metastatic RCC receiving definitive local therapies.