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Lesion detection by [89Zr]Zr-DFO-girentuximab and [18F]FDG-PET/CT in patients with newly diagnosed metastatic renal cell carcinoma.

Abstract

PURPOSE

The main objective of this preliminary analysis of the IMaging PAtients for Cancer drug selecTion (IMPACT)-renal cell cancer (RCC) study is to evaluate the lesion detection of baseline contrast-enhanced CT, [89Zr]Zr-DFO-girentuximab-PET/CT and [18F]FDG-PET/CT in detecting ccRCC lesions in patients with a good or intermediate prognosis metastatic clear cell renal cell carcinoma (mccRCC) according to the International Metastatic Database Consortium (IMDC) risk model.

METHODS

Between February 2015 and March 2018, 42 newly diagnosed mccRCC patients with good or intermediate prognosis, eligible for watchful waiting, were included. Patients underwent CT, [89Zr]Zr-DFO-girentuximab-PET/CT and [18F]FDG-PET/CT at baseline. Scans were independently reviewed and lesions of ≥10 mm and lymph nodes of ≥15 mm at CT were analyzed. For lesions with [89Zr]Zr-DFO-girentuximab or [18F]FDG-uptake visually exceeding background uptake, maximum standardized uptake values (SUVmax) were measured.

RESULTS

A total of 449 lesions were detected by ≥1 modality (median per patient: 7; ICR 4.25-12.75) of which 42% were in lung, 22% in lymph nodes and 10% in bone. Combined [89Zr]Zr-DFO-girentuximab-PET/CT and CT detected more lesions than CT alone: 91% (95%CI: 87-94) versus 56% (95%CI: 50-62, p = 0.001), respectively, and more than CT and [18F]FDG-PET/CT combined (84% (95%CI:79-88, p < 0.005). Both PET/CTs detected more bone and soft tissue lesions compared to CT alone.

CONCLUSIONS

The addition of [89Zr]Zr-DFO-girentuximab-PET/CT and [18F]FDG-PET/CT to CT increases lesion detection compared to CT alone in newly diagnosed good and intermediate prognosis mccRCC patients eligible for watchful waiting.

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  • Authors+Show Affiliations

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    Department of Medical Oncology, Radboud University Medical Center Nijmegen, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.

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    Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

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    Department of Medical Oncology, Radboud University Medical Center Nijmegen, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.

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    Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam, The Netherlands.

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    Departments of Medical Oncology and Radiology & Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.

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    Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.

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    Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

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    Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.

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    Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

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    Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.

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    Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.

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    Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands.

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    Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam, The Netherlands.

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    Departments of Medical Oncology and Radiology & Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.

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    Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

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    Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.

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    Department of Medical Oncology, Radboud University Medical Center Nijmegen, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands. Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands.

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    Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands. Department of Radiology and Nuclear Medicine, Rijnstate, Arnhem, The Netherlands. Department of Biomedical Sciences, Humanitas University, Milan, Italy.

    Department of Medical Oncology, Radboud University Medical Center Nijmegen, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands. Carla.vanherpen@radboudumc.nl.

    Source

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    31172212

    Citation

    Verhoeff, Sarah R., et al. "Lesion Detection By [89Zr]Zr-DFO-girentuximab and [18F]FDG-PET/CT in Patients With Newly Diagnosed Metastatic Renal Cell Carcinoma." European Journal of Nuclear Medicine and Molecular Imaging, vol. 46, no. 9, 2019, pp. 1931-1939.
    Verhoeff SR, van Es SC, Boon E, et al. Lesion detection by [89Zr]Zr-DFO-girentuximab and [18F]FDG-PET/CT in patients with newly diagnosed metastatic renal cell carcinoma. Eur J Nucl Med Mol Imaging. 2019;46(9):1931-1939.
    Verhoeff, S. R., van Es, S. C., Boon, E., van Helden, E., Angus, L., Elias, S. G., ... van Herpen, C. M. L. (2019). Lesion detection by [89Zr]Zr-DFO-girentuximab and [18F]FDG-PET/CT in patients with newly diagnosed metastatic renal cell carcinoma. European Journal of Nuclear Medicine and Molecular Imaging, 46(9), pp. 1931-1939. doi:10.1007/s00259-019-04358-9.
    Verhoeff SR, et al. Lesion Detection By [89Zr]Zr-DFO-girentuximab and [18F]FDG-PET/CT in Patients With Newly Diagnosed Metastatic Renal Cell Carcinoma. Eur J Nucl Med Mol Imaging. 2019;46(9):1931-1939. PubMed PMID: 31172212.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Lesion detection by [89Zr]Zr-DFO-girentuximab and [18F]FDG-PET/CT in patients with newly diagnosed metastatic renal cell carcinoma. AU - Verhoeff,Sarah R, AU - van Es,Suzanne C, AU - Boon,Eline, AU - van Helden,Erik, AU - Angus,Lindsay, AU - Elias,Sjoerd G, AU - Oosting,Sjoukje F, AU - Aarntzen,Erik H, AU - Brouwers,Adrienne H, AU - Kwee,Thomas C, AU - Heskamp,Sandra, AU - Hoekstra,Otto S, AU - Verheul,Henk, AU - van der Veldt,Astrid A M, AU - de Vries,Elisabeth G E, AU - Boerman,Otto C, AU - van der Graaf,Winette T A, AU - Oyen,Wim J G, AU - van Herpen,Carla M L, Y1 - 2019/06/06/ PY - 2019/01/29/received PY - 2019/05/02/accepted PY - 2019/6/7/pubmed PY - 2019/6/7/medline PY - 2019/6/8/entrez KW - CAIX KW - Clear cell renal cell carcinoma KW - FDG KW - Girentuximab KW - Imaging KW - PET SP - 1931 EP - 1939 JF - European journal of nuclear medicine and molecular imaging JO - Eur. J. Nucl. Med. Mol. Imaging VL - 46 IS - 9 N2 - PURPOSE: The main objective of this preliminary analysis of the IMaging PAtients for Cancer drug selecTion (IMPACT)-renal cell cancer (RCC) study is to evaluate the lesion detection of baseline contrast-enhanced CT, [89Zr]Zr-DFO-girentuximab-PET/CT and [18F]FDG-PET/CT in detecting ccRCC lesions in patients with a good or intermediate prognosis metastatic clear cell renal cell carcinoma (mccRCC) according to the International Metastatic Database Consortium (IMDC) risk model. METHODS: Between February 2015 and March 2018, 42 newly diagnosed mccRCC patients with good or intermediate prognosis, eligible for watchful waiting, were included. Patients underwent CT, [89Zr]Zr-DFO-girentuximab-PET/CT and [18F]FDG-PET/CT at baseline. Scans were independently reviewed and lesions of ≥10 mm and lymph nodes of ≥15 mm at CT were analyzed. For lesions with [89Zr]Zr-DFO-girentuximab or [18F]FDG-uptake visually exceeding background uptake, maximum standardized uptake values (SUVmax) were measured. RESULTS: A total of 449 lesions were detected by ≥1 modality (median per patient: 7; ICR 4.25-12.75) of which 42% were in lung, 22% in lymph nodes and 10% in bone. Combined [89Zr]Zr-DFO-girentuximab-PET/CT and CT detected more lesions than CT alone: 91% (95%CI: 87-94) versus 56% (95%CI: 50-62, p = 0.001), respectively, and more than CT and [18F]FDG-PET/CT combined (84% (95%CI:79-88, p < 0.005). Both PET/CTs detected more bone and soft tissue lesions compared to CT alone. CONCLUSIONS: The addition of [89Zr]Zr-DFO-girentuximab-PET/CT and [18F]FDG-PET/CT to CT increases lesion detection compared to CT alone in newly diagnosed good and intermediate prognosis mccRCC patients eligible for watchful waiting. SN - 1619-7089 UR - https://www.unboundmedicine.com/medline/citation/31172212/Lesion_detection_by_[89Zr]Zr-DFO-girentuximab_and_[18F]FDG-PET/CT_in_patients_with_newly_diagnosed_metastatic_renal_cell_carcinoma L2 - https://dx.doi.org/10.1007/s00259-019-04358-9 DB - PRIME DP - Unbound Medicine ER -