Metabolic parameters analysis of ¹⁸F-FDG PET/CT in the diagnosis and differential diagnosis of collecting duct carcinoma.

IF 1.8 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING American journal of nuclear medicine and molecular imaging Pub Date : 2025-02-25 eCollection Date: 2025-01-01 DOI:10.62347/KQJB5668

Yongkang Qiu, Xiaoyue Zhang, Jia Cheng, Wenpeng Huang, Zhao Chen, Lele Song, Qi Yang, Xinyao Sun, Aixiang Wang, Tianyao Wang, Lei Kang

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Abstract

Purpose: This study aims to explore the diagnostic performance of ¹⁸F-FDG PET/CT in distinguishing collecting duct carcinoma (CDC) from clear cell renal cell carcinoma (ccRCC).

Methods: A retrospective analysis was conducted on 11 patients with CDC and 27 patients with ccRCC who underwent ¹⁸F-FDG PET/CT examinations. Clinical indicators and the SUVmax, tumor-to-liver standardized uptake value ratio (TLR), tumor-to-kidney standardized uptake value ratio (TKR), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) values of the primary tumor, whole-body MTV (WBMTV), and whole-body TLG (WBTLG) based on a baseline PET scan, were recorded and compared between the two groups. To assess the discriminative power of these metabolic parameters between CDC and ccRCC, we performed a receiver operating characteristic (ROC) curve analysis.

Results: The median age of the 11 CDC patients was 59 years. All CDC patients were in advanced stages (18% stage III and 82% stage IV). Compare with ccRCC patients, CDC patients had higher lymph node metastases rates (72.7% vs. 22.2%, P = 0.008) and distant metastases rates (81.8% vs. 22.2%, P = 0.001). The primary tumor in CDC also showed higher SUVmax (10.5 vs. 4.0, P < 0.001), TLR (3.9 vs. 1.4, P < 0.001), TKR (4.4 vs. 1.5, P < 0.001), MTV (53.2 vs. 9.5, P = 0.021), and TLG (305.7 vs. 30.4, P = 0.0069) than ccRCC. The WBMTV and WBTLG of CDC patients were also higher than the ccRCC group (144.1 vs. 9.5, P = 0.0013 and 528.4 vs. 30.4, P = 0.0013, respectively). ROC curve analysis revealed no significant differences in the ability of SUVmax, TLR and TKR to differentiate CDC from ccRCC. Median survival for CDC was 36 months, worse for older patients.

Conclusion: The utilization of ¹⁸F-FDG PET/CT can assist to detect the metastases and provide guidance for diagnosis and staging. Metabolic parameters obtained from ¹⁸F-FDG PET/CT hold promise for distinguishing CDC from ccRCC.

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18F-FDG PET/CT代谢参数在集管癌诊断及鉴别诊断中的分析

目的：探讨18F-FDG PET/CT在鉴别集管癌（CDC）与透明细胞肾细胞癌（ccRCC）中的诊断价值。方法：回顾性分析11例CDC和27例ccRCC患者行18F-FDG PET/CT检查的资料。记录两组临床指标及SUVmax、肿瘤-肝脏标准化摄取值比（TLR）、肿瘤-肾脏标准化摄取值比（TKR）、肿瘤代谢体积（MTV）、原发肿瘤总糖酵解（TLG）值、全身MTV （WBMTV）、基于基线PET扫描的全身TLG （WBTLG）进行比较。为了评估这些代谢参数在CDC和ccRCC之间的判别能力，我们进行了受试者工作特征（ROC）曲线分析。结果：11例CDC患者中位年龄为59岁。CDC患者均为晚期（18%为III期，82%为IV期），与ccRCC患者相比，CDC患者的淋巴结转移率（72.7%比22.2%,P = 0.008）和远处转移率（81.8%比22.2%,P = 0.001）更高。CDC原发肿瘤的SUVmax （10.5 vs. 4.0, P < 0.001）、TLR （3.9 vs. 1.4, P < 0.001）、TKR （4.4 vs. 1.5, P < 0.001）、MTV （53.2 vs. 9.5, P = 0.021）、TLG （305.7 vs. 30.4, P = 0.0069）均高于ccRCC。CDC组患者WBMTV和WBTLG均高于ccRCC组（分别为144.1比9.5,P = 0.0013和528.4比30.4,P = 0.0013）。ROC曲线分析显示，SUVmax、TLR和TKR对CDC和ccRCC的区分能力无显著差异。CDC患者的中位生存期为36个月，老年患者的中位生存期更差。结论：利用18F-FDG PET/CT可以帮助发现转移灶，指导诊断和分期。从18F-FDG PET/CT获得的代谢参数有望区分CDC和ccRCC。

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来源期刊

American journal of nuclear medicine and molecular imaging RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

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4.00%

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期刊介绍： The scope of AJNMMI encompasses all areas of molecular imaging, including but not limited to: positron emission tomography (PET), single-photon emission computed tomography (SPECT), molecular magnetic resonance imaging, magnetic resonance spectroscopy, optical bioluminescence, optical fluorescence, targeted ultrasound, photoacoustic imaging, etc. AJNMMI welcomes original and review articles on both clinical investigation and preclinical research. Occasionally, special topic issues, short communications, editorials, and invited perspectives will also be published. Manuscripts, including figures and tables, must be original and not under consideration by another journal.