Characterisation of Renal Cancer by Prostate Specific Membrane Antigen (PSMA) PET/CT in comparison to standard of care imaging: a multi-institutional series
BAUS ePoster online library. Tariq A. 06/23/21; 319028; p12-1
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Dr. Arsalan Tariq
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Abstract
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Introduction: Accurate characterisation of renal tumours is an ongoing challenge. Given the novel implications of PSMA in non-prostatic malignancies, we sought to further define the role of PSMA-based Imaging in renal cancer. The objective of this study was to determine diagnostic accuracy of primary lesions, nodal & distant metastasis with PSMA PET/CT compared to standard of care (SOC) imaging and histopathology.
Material & Methods: A retrospective cohort study was undertaken of all PSMA PET/CT scans performed for primary or recurrent staging of renal cell carcinoma (RCC) and incidental renal lesions at 3 sites in Brisbane, Australia between June 2015 to June 2020. Clinical characteristics, imaging findings, and histopathology were reviewed.
Results: 113 PSMA PET/CT scans were reviewed (53 staging, 47 re-staging & 13 incidental) of mostly men (75%) with a median age of 65 years (IQR 14 years). From histopathology for 55 primary lesions, 50 were PSMA avid (90.91%). Clear Cell RCC represented 42 of these primary lesions (94% PSMA Avid). PSMA identified a greater number of nodal or metastatic lesions than SOC imaging for 37% of patients and refuted SOC imaging findings for 12%. PSMA had a Positive Predictive Value of 91% (SOC imaging 53%) and Negative Predictive Value of 76% (SOC Imaging 29%) in lymph nodes. Overall, 38% of patients had their treatment modified due to PSMA PET/CT.
Conclusions: Most (91%) primary tumours were PSMA avid, leading to improved diagnostic accuracy for PSMA PET/CT compared to SOC imaging and treatment modification. Further assessment in prospective studies is warranted.
Material & Methods: A retrospective cohort study was undertaken of all PSMA PET/CT scans performed for primary or recurrent staging of renal cell carcinoma (RCC) and incidental renal lesions at 3 sites in Brisbane, Australia between June 2015 to June 2020. Clinical characteristics, imaging findings, and histopathology were reviewed.
Results: 113 PSMA PET/CT scans were reviewed (53 staging, 47 re-staging & 13 incidental) of mostly men (75%) with a median age of 65 years (IQR 14 years). From histopathology for 55 primary lesions, 50 were PSMA avid (90.91%). Clear Cell RCC represented 42 of these primary lesions (94% PSMA Avid). PSMA identified a greater number of nodal or metastatic lesions than SOC imaging for 37% of patients and refuted SOC imaging findings for 12%. PSMA had a Positive Predictive Value of 91% (SOC imaging 53%) and Negative Predictive Value of 76% (SOC Imaging 29%) in lymph nodes. Overall, 38% of patients had their treatment modified due to PSMA PET/CT.
Conclusions: Most (91%) primary tumours were PSMA avid, leading to improved diagnostic accuracy for PSMA PET/CT compared to SOC imaging and treatment modification. Further assessment in prospective studies is warranted.
Introduction: Accurate characterisation of renal tumours is an ongoing challenge. Given the novel implications of PSMA in non-prostatic malignancies, we sought to further define the role of PSMA-based Imaging in renal cancer. The objective of this study was to determine diagnostic accuracy of primary lesions, nodal & distant metastasis with PSMA PET/CT compared to standard of care (SOC) imaging and histopathology.
Material & Methods: A retrospective cohort study was undertaken of all PSMA PET/CT scans performed for primary or recurrent staging of renal cell carcinoma (RCC) and incidental renal lesions at 3 sites in Brisbane, Australia between June 2015 to June 2020. Clinical characteristics, imaging findings, and histopathology were reviewed.
Results: 113 PSMA PET/CT scans were reviewed (53 staging, 47 re-staging & 13 incidental) of mostly men (75%) with a median age of 65 years (IQR 14 years). From histopathology for 55 primary lesions, 50 were PSMA avid (90.91%). Clear Cell RCC represented 42 of these primary lesions (94% PSMA Avid). PSMA identified a greater number of nodal or metastatic lesions than SOC imaging for 37% of patients and refuted SOC imaging findings for 12%. PSMA had a Positive Predictive Value of 91% (SOC imaging 53%) and Negative Predictive Value of 76% (SOC Imaging 29%) in lymph nodes. Overall, 38% of patients had their treatment modified due to PSMA PET/CT.
Conclusions: Most (91%) primary tumours were PSMA avid, leading to improved diagnostic accuracy for PSMA PET/CT compared to SOC imaging and treatment modification. Further assessment in prospective studies is warranted.
Material & Methods: A retrospective cohort study was undertaken of all PSMA PET/CT scans performed for primary or recurrent staging of renal cell carcinoma (RCC) and incidental renal lesions at 3 sites in Brisbane, Australia between June 2015 to June 2020. Clinical characteristics, imaging findings, and histopathology were reviewed.
Results: 113 PSMA PET/CT scans were reviewed (53 staging, 47 re-staging & 13 incidental) of mostly men (75%) with a median age of 65 years (IQR 14 years). From histopathology for 55 primary lesions, 50 were PSMA avid (90.91%). Clear Cell RCC represented 42 of these primary lesions (94% PSMA Avid). PSMA identified a greater number of nodal or metastatic lesions than SOC imaging for 37% of patients and refuted SOC imaging findings for 12%. PSMA had a Positive Predictive Value of 91% (SOC imaging 53%) and Negative Predictive Value of 76% (SOC Imaging 29%) in lymph nodes. Overall, 38% of patients had their treatment modified due to PSMA PET/CT.
Conclusions: Most (91%) primary tumours were PSMA avid, leading to improved diagnostic accuracy for PSMA PET/CT compared to SOC imaging and treatment modification. Further assessment in prospective studies is warranted.
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