MP64-17 THE ROLE OF 18-FDG PET/CT SCAN IN EARLY RESPONSE TO SYSTEMIC THERAPY FOR METASTATIC RENAL CELL CARCINOMA: BEYOND SUV max

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP64-17 THE ROLE OF 18-FDG PET/CT SCAN IN EARLY RESPONSE TO SYSTEMIC THERAPY FOR METASTATIC RENAL CELL CARCINOMA: BEYOND SUVmax Sanjoy Kumar Sureka, Sumit Mandal, and Uday Pratap Singh Sanjoy Kumar SurekaSanjoy Kumar Sureka More articles by this author , Sumit MandalSumit Mandal More articles by this author , and Uday Pratap SinghUday Pratap Singh More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003322.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In metastatic renal cell carcinoma (RCC), the CECT scan evaluates lesions in their anatomic context while FDG-PET/CT scan demonstrates metabolic component. Often the size of the lesion may take time to respond and metabolic activity changes first. We evaluated the role of FDG PET/CT scan in this setting with an objective to evaluate the role of FDG-PET/CT as a monitoring tool for early response to systemic therapy in metastatic RCC. METHODS: From January 2017 to Dec 2021, 48 patients with synchronous and metachronous metastatic RCC with ECOG <2 underwent a baseline 18-FDG/PET-CT scan followed by repeat scan for response assessment 3 months later. Pregnant and nursing mothers, hypothyroid, diabetics and those with brain metastasis or another malignancy were excluded. Response evaluation was done with both RECIST version 1.1 (for CECT) and PERCIST (for PET-CT) criteria. Also, total lesion glycolysis (TLG), and metabolic tumour volume (MTV) were assessed. Interrater agreement was done using Cohen’s kappa between the scores. RESULTS: Mean age of 48 patients was 55.3±5.6 years and 28(58.3%) were males. Clear cell histology was present in 44 patients. Sunitinib, Pazopanib, Everolimus and Axitinib were given to 12, 22, 6 and 8 patients respectively. Out of 22 patients with partial response (PR) in RECIST, 8 patients were upgraded to Stable disease (SD) in 2 and Progressive disease (PD) in 6 as per PERCIST, subsequently leading to a change in their management. All 14 patients with PR in PERCIST had better long-term survival as compared to the rest upgraded 8. There was a significant decline in median SUVmax, MTV and TLG after 3 months in these patients. CONCLUSIONS: 18-FDG PET/CT scan is useful for monitoring the early response to systemic therapy in metastatic RCC based on 18-FDG avidity including TLG & MTV and correctly identifying partial responders. Changes in the metabolic parameters detect response to therapy earlier and guide subsequent changes in therapy. Source of Funding: None. © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e887 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sanjoy Kumar Sureka More articles by this author Sumit Mandal More articles by this author Uday Pratap Singh More articles by this author Expand All Advertisement PDF downloadLoading ...