title: Pilot study: use of gallium-68 PSMA PET for detection of metastatic lesions in patients with renal tumour.
abstract: BACKGROUND
  In this study, we prospectively evaluate the diagnostic potential of a gallium-68 (68Ga) prostate-specific membrane antigen (PSMA)-binding ligand and positron emission tomography (PET) in detecting metastatic lesions in patients with renal tumour. The secondary aim was to determine whether the findings would result in the alteration of patient management.
  
  
  RESULTS
  Ten patients with renal lesion and potential metastatic disease on conventional imaging were recruited. Patients underwent PSMA PET in addition to standard imaging. Nine patients underwent nephrectomy and 4 patients underwent additional targeted biopsy to provide specimens for histopathological validation. There were 89 pathological lesions on CT, of which 32 were removed or biopsied for histopathological correlation. With PSMA PET, 86 PET avid lesions were identified with 36 samples being available for analysis. Thirty-five of 36 samples were positive for renal cell carcinoma deposits, whilst 1 sample was inconclusive for diagnosis on biopsy. For the histologically confirmed lesions, there were no false-negative PSMA PET lesions; however, CT was false negative in 11. In two patients, surgical strategies were changed based on PSMA PET findings.
  
  
  CONCLUSIONS
  PSMA PET may potentially have a role in the preoperative staging of advanced renal cell carcinoma as PET detected multiple histologically proven metastatic lesions which were false negative on CT scanning, resulting in change in surgical strategies in some patients. We cautiously support a larger study to confirm these results and to assess the longitudinal impact on patient outcomes.
  
  
  BACKGROUND
  Australia and New Zealand Clinical Trial Registry (ANZCTR), ACTRN12615000854538 .
authors: Department of Urology, Princess Alexandra Hospital, Brisbane, QLD 4102, Australia. handoorhee@gmail.com.|University of Queensland, School of Medicine, Brisbane, Australia. handoorhee@gmail.com.
authors: Handoo
authors: http://orcid.org/0000-0002-1722-7127
authors: H
authors: Rhee
authors: Department of Nuclear Medicine, Royal Brisbane and Women's Hospital, Brisbane, Australia.
authors: John
authors: J
authors: Blazak
authors: Department of Urology, Princess Alexandra Hospital, Brisbane, QLD 4102, Australia.
authors: Chui Ming
authors: CM
authors: Tham
authors: Department of Urology, Princess Alexandra Hospital, Brisbane, QLD 4102, Australia.|University of Queensland, School of Medicine, Brisbane, Australia.
authors: Keng Lim
authors: KL
authors: Ng
authors: Pathology Queensland, Princess Alexandra Hospital, Brisbane, Australia.
authors: Benjamin
authors: B
authors: Shepherd
authors: Department of Urology, Princess Alexandra Hospital, Brisbane, QLD 4102, Australia.
authors: Malcolm
authors: M
authors: Lawson
authors: Department of Urology, Princess Alexandra Hospital, Brisbane, QLD 4102, Australia.
authors: John
authors: J
authors: Preston
authors: Department of Urology, Princess Alexandra Hospital, Brisbane, QLD 4102, Australia.|University of Queensland, School of Medicine, Brisbane, Australia.
authors: Ian
authors: I
authors: Vela
authors: Department of Nuclear Medicine, Royal Brisbane and Women's Hospital, Brisbane, Australia.|University of Queensland, School of Medicine, Brisbane, Australia.
authors: Paul
authors: P
authors: Thomas
authors: Department of Urology, Princess Alexandra Hospital, Brisbane, QLD 4102, Australia.|University of Queensland, School of Medicine, Brisbane, Australia.
authors: Simon
authors: S
authors: Wood
keywords: Metastasis; Nephrectomy; PET; PSMA; Renal cell carcinoma