title: Evaluation of FDG uptake by renal malignancies (primary tumor or metastases) using a coincidence detection gamma camera.
abstract: The aim of this study was to evaluate the usefulness of FDG scanning using an ordinary gamma camera equipped with coincidence detection (CDET) for 2 renal cancer indications: characterization and staging of renal masses before nephrectomy and search for recurrence after nephrectomy.
  
  
  METHODS
  Between September 1997 and June 1998, a whole-body scan and at least 1 tomoscintigram were obtained on 23 occasions in 22 patients (fasting for at least 6 h) using a Prism XP 2000 CDET gamma camera; scanning was begun 45 min after intravenous injection of 150-250 MBq FDG.
  
  
  RESULTS
  Postoperative histologic evidence was obtained from 13 of 16 patients who underwent FDG using a CDET gamma camera before renal surgery; 4 renal masses did not accumulate FDG (3 true-negatives, 1 false-negative), whereas 9 renal tumors accumulated FDG (8 true-positives, 1 false-positive). In the other 3 patients, only 1 extrarenal site of FDG uptake was checked and confirmed on histologic examination: a bone metastasis from renal cell carcinoma in 2 cases and lymph node metastasis from a squamous cell carcinoma (3 true-positives). The primary local and regional staging of the malignant renal tumors was accurate in the 9 patients who underwent nephrectomy (8 true-negatives, 1 true-positive). The primary distant staging was positive in 1 case (focus in the chest corresponding to a probable true-positive on follow-up). In the 7 examinations performed because of suspected recurrence of renal cell carcinoma several months after nephrectomy, metastases were visualized by FDG in 4 patients, confirmed by biopsy in 2 patients, and confirmed by conventional imaging or follow-up (or both) in 2 patients. The other 3 patients had negative FDG scans, corresponding to probable true-negative results on follow-up.
  
  
  CONCLUSIONS
  FDG using a CDET gamma camera can be used effectively for the staging and restaging of renal tumors and might be useful for characterization of the primary renal tumor in doubtful cases.
authors.affiliation: Services de Médecine Nucléaire, Hôpital Tenon, Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Montravers
authors.forename: D
authors.initials: D
authors.lastname: Grahek
authors.forename: K
authors.initials: K
authors.lastname: Kerrou
authors.forename: N
authors.initials: N
authors.lastname: Younsi
authors.forename: J D
authors.initials: JD
authors.lastname: Doublet
authors.forename: B
authors.initials: B
authors.lastname: Gattegno
authors.forename: J
authors.initials: J
authors.lastname: Rossert
authors.forename: M A
authors.initials: MA
authors.lastname: Costa de Beauregard
authors.forename: P
authors.initials: P
authors.lastname: Thibault
authors.forename: J N
authors.initials: JN
authors.lastname: Talbot
mesh_terms: D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging; D005260:Female; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D015902:Gamma Cameras; D006801:Humans; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging; D009367:Neoplasm Staging; D009392:Nephrectomy; D019275:Radiopharmaceuticals; D014055:Tomography, Emission-Computed
chemical_list: D005462:Fluorine Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18