Abstract
PurposeDetection of residual or recurrent vital renal tumor on follow-up (FU) cross-sectional imaging after ablative therapy is challenging. The specific and high expression levels of carbonic anhydrase IX (CAIX) in clear cell renal cell carcinoma (ccRCC) makes it a suitable target for imaging using radiolabeled anti-CAIX antibody girentuximab. The objective of this study was to evaluate the feasibility of targeted FU imaging 1 month after cryoablation of ccRCC using single photon emission computed tomography (SPECT) after 111In-labeled girentuximab administration.MethodsIn this prospective study 16 patients underwent 111In-girentuximab-SPECT before MR-guided renal cryoablation between February 2015 and September 2018. In case of tumor targeting 111In-girentuximab-SPECT was repeated 1 month following MR-guided cryoablation. Presence of residual or recurrent vital tumor was assessed on contrast-enhanced cross-sectional imaging during further FU. The standard FU imaging protocol consisted of MRI/CT scans at 1, 3, 6, 12, and 18 months and annually thereafter.ResultsA total of 10 (63%) patients showed positive tumor targeting on 111In-girentuximab-SPECT before cryoablation and 9 ( 56%) were eligible to undergo FU SPECT. Of the 9 111In-girentuximab-SPECT FU scans, 8 (89%) were considered negative. One (11%) scan showed uptake suggestive for residual vital tumor. Six months after treatment, FU CT showed contrast enhancement suggestive for residual/recurrent disease in the ablated zone at the site of the 111In-girentuximab uptake after treatment. During a mean FU of 21 months (range 1–33) no other cases with residual/recurrent disease were detected.ConclusionFU imaging with 111In-girentuximab-SPECT is feasible after ccRCC cryoablation and may contribute to early detection of residual or recurrent disease.
Highlights
The detection of residual or recurrent disease after ablative therapy of renal tumors on follow-up (FU) cross-sectionalThis article is part of the Topical Collection on Oncology – GenitourinaryOf all renal malignancies, 75% are clear cell renal cell carcinomas [3]
Because of the high and specific expression levels of carbonic anhydrase IX (CAIX) in 95% of clear cell renal cell carcinomas (ccRCC), radiolabeled anti-CAIX chimeric monoclonal antibody girentuximab can be used for the detection of ccRCC [4, 5]
CAIX antibody girentuximab labeled with 111Indium can overcome the issue of inconclusive findings on contrastenhanced cross-sectional FU imaging findings after cryoablation
Summary
The detection of residual or recurrent disease after ablative therapy of renal tumors on follow-up (FU) cross-sectionalThis article is part of the Topical Collection on Oncology – GenitourinaryOf all renal malignancies, 75% are clear cell renal cell carcinomas (ccRCC) [3]. The detection of residual or recurrent disease after ablative therapy of renal tumors on follow-up (FU) cross-sectional. This article is part of the Topical Collection on Oncology – Genitourinary. 75% are clear cell renal cell carcinomas (ccRCC) [3]. Because of the high and specific expression levels of carbonic anhydrase IX (CAIX) in 95% of ccRCC, radiolabeled anti-CAIX chimeric monoclonal antibody girentuximab can be used for the detection of ccRCC [4, 5]. Previous studies have shown high accuracy in the detection of ccRCC using single photon emission computed tomography (SPECT) with girentuximab radiolabeled with 111Indium (111In) [6]. Eur J Nucl Med Mol Imaging (2020) 47:1864–1870. The objective of this study was to evaluate the feasibility of targeted FU imaging 1 month after magnetic resonance (MR)guided cryoablation using SPECT after 111In-labeled girentuximab administration
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