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1.
Mol Imaging Biol ; 2024 Jul 29.
Artículo en Inglés | MEDLINE | ID: mdl-39078524

RESUMEN

PURPOSE: Indeterminate renal masses are increasingly incidentally found on cross-sectional imaging. 99mTc-sestamibi single-photon emission computed tomography/computed tomography (SPECT/CT) scans can be used to identify oncocytomas and oncocytic renal neoplasms, including a subset of chromophobe renal cell carcinomas (chRCCs), which are viewed as false-positive. PROCEDURE: Patients imaged with renal sestamibi scans between 2014 and 2023 were reviewed. Those patients with solitary tumors that were originally classified as chRCC were included in the analysis. Imaging with SPECT/CT from the liver dome down had been carried out 75 min after the administration of 925 MBq of 99mTc-sestamibi. All available H&E and immunostained slides were re-reviewed and classified according to WHO 2022 criteria. Confirmatory immunohistochemical stains were performed in tumors considered morphologically suspicious for non-chRCC entities. RESULT: A total of 18 patients with solitary tumors were included in the final analysis. 13/18 (72.2%) tumors in this cohort remained classified as chRCC, with 4/18 (22.2%) being eosinophilic-variant chRCC. The reclassified tumors (5/18 [27.8%]) included 2/18 (11.1%) low-grade oncocytic tumor (LOT), 1/18 (5.5%) eosinophilic vacuolated tumor (EVT), and 2/18 (11.1%) unclassified low-grade oncocytic neoplasms. As such, only 2/9 (22.2%) qualitatively "hot" tumors were chRCC other than eosinophilic-variant and only 1/9 (11.1%) "cold" tumors was a histology other than chRCC. CONCLUSION: Based on current histopathologic classification methods, it is likely that the "false-positive" rate of uptake on renal sestamibi scans with chRCC has been over-stated. Further study is warranted to better refine the optimal utility of renal sestamibi scans for non-invasive risk stratification of indeterminate renal masses.

3.
Appl Immunohistochem Mol Morphol ; 31(8): 544-549, 2023 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-37471632

RESUMEN

Multiple studies have demonstrated prostate-specific membrane antigen (PSMA) expression in the neo-vasculature of non-prostate tumors including clear cell renal cell carcinoma (ccRCC). However, PSMA expression in rare renal tumors including MiTF family translocation renal cell carcinoma has not been previously characterized. We examined PSMA expression by immunohistochemistry in a series of MiTF family translocation renal cell carcinomas as well as in several genetically related tumors including alveolar soft part sarcoma and PEComas with TFE3 rearrangements. PSMA expression was also studied in several cases of ccRCC and papillary RCC. Overall, PSMA immunohistochemistry was performed in 61 samples from 58 patients. Vascular PSMA expression was seen with the highest frequency in ccRCC [88% (14/16)] (38% focal, 50% diffuse). Translocation RCC (tRCC) demonstrated the second highest frequency of PSMA expression [71% (22/28)] (57% focal, 14% diffuse), followed by alveolar soft part sarcoma [50% (4/8)] (38% focal, 12% diffuse). No PSMA expression was seen in PEComas with TFE3 rearrangement (0/3) or papillary RCC (0/6). PSMA expression was only present in tumor-associated neo-vasculature. A patient with oligometastatic tRCC underwent 68 Ga-PSMA-11 PET imaging which detected multiple putative metastatic lesions not detected on conventional computed tomography imaging performed 2 weeks prior, supporting the potential utility of PSMA imaging in tRCC. These findings have potential implications for the utility of PSMA guided diagnostic and therapeutic agents in both common and uncommon renal cell carcinoma subtypes as well as genetically related mesenchymal neoplasms.


Asunto(s)
Carcinoma de Células Renales , Neoplasias Renales , Sarcoma de Parte Blanda Alveolar , Humanos , Carcinoma de Células Renales/diagnóstico , Carcinoma de Células Renales/genética , Carcinoma de Células Renales/metabolismo , Neoplasias Renales/metabolismo , Translocación Genética , Inmunohistoquímica
4.
Nucl Med Commun ; 38(9): 795-798, 2017 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-28704341

RESUMEN

OBJECTIVE: PET imaging using radiotracers that target prostate-specific membrane antigen (PSMA) are increasingly being used in the evaluation of men with prostate cancer (PCa). It is therefore of increasing importance for imaging specialists to recognize potential pitfalls of this novel imaging technique. In this report, we describe a series of benign elastofibroma dorsi with uptake of the PSMA-targeted PET radiotracer F-DCFPyL. PATIENTS AND METHODS: We retrospectively analyzed the imaging data of 75 men with PCa who were consecutively imaged with F-DCFPyL PET/CT. Acquired images were reviewed for the presence of radiotracer uptake in the region of the scapular tip adjacent to the chest wall. Only those lesions with discrete radiotracer uptake corresponding to an area on CT with the characteristic appearance of an elastofibroma were considered positive. RESULTS: In total, 18/75 (24.0%) patients had evidence of at least one elastofibroma dorsi on F-DCFPyL PET/CT. Eight (44.4%) of these patients had unilateral lesions, all of which were right sided. Detected lesions had a median maximal diameter of 2.3 cm (range: 1.3-8.4 cm) and a median perpendicular thickness to the chest wall of 0.9 cm (range: 0.6-2.5 cm). The median maximum standardized uptake value of detected lesions was 1.4 (range: 1.1-2.4) and the median maximum standardized uptake value corrected to lean body mass was 1.1 (range: 0.8-1.7). CONCLUSION: This study is the first to report uptake of a PSMA-targeted PET radiotracer in elastofibroma dorsi. Radiotracer uptake in these benign lesions should not be falsely mistaken as sites of metastatic PCa.


Asunto(s)
Antígenos de Superficie/metabolismo , Glutamato Carboxipeptidasa II/metabolismo , Lisina/análogos & derivados , Tomografía de Emisión de Positrones/métodos , Neoplasias de la Próstata/diagnóstico por imagen , Neoplasias de la Próstata/metabolismo , Neoplasias de los Tejidos Blandos/diagnóstico por imagen , Neoplasias de los Tejidos Blandos/metabolismo , Urea/análogos & derivados , Anciano , Anciano de 80 o más Años , Biomarcadores de Tumor/metabolismo , Simulación por Computador , Diagnóstico Diferencial , Humanos , Interpretación de Imagen Asistida por Computador/métodos , Lisina/farmacocinética , Masculino , Tasa de Depuración Metabólica , Persona de Mediana Edad , Modelos Biológicos , Radiofármacos/farmacocinética , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Distribución Tisular , Urea/farmacocinética
6.
Clin Nucl Med ; 41(1): 83-5, 2016 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-26402128

RESUMEN

Renal cell carcinoma (RCC) is common with more than 60,000 new cases in the United States yearly. No curative therapies are available for metastatic RCC. Improved methods of imaging metastatic RCC would be of value in identifying sites of occult disease and potentially for judging response to therapy. A 58-year-old man with known metastatic clear cell RCC was imaged with both 18F-FDG and 18F-DCFPyL PET/CT. 18F-DCFPyL is a small molecule inhibitor of the prostate-specific membrane antigen (PSMA), a target known to be highly expressed on solid tumor neovasculature. Relative to 18F-FDG, 18F-DCFPyL identified more lesions and demonstrated higher tumor radiotracer uptake.


Asunto(s)
Carcinoma de Células Renales/diagnóstico por imagen , Carcinoma de Células Renales/patología , Fluorodesoxiglucosa F18 , Humanos , Lisina/análogos & derivados , Masculino , Persona de Mediana Edad , Imagen Multimodal , Metástasis de la Neoplasia , Tomografía de Emisión de Positrones , Radiofármacos , Tomografía Computarizada por Rayos X , Urea/análogos & derivados
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