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Use of NaF-18-Positron Emission Tomography/Computed Tomography in the Detection of Bone Metastasis from Papillary Renal Cell Carcinoma.

Aparici CM, Win AZ - World J Nucl Med (2014)

Bottom Line: A solitary metastatic bony lesion was detected by CT 4 years after partial nephrectomy and it was confirmed by NaF-positron emission tomography (PET)/CT and magnetic resonance imaging.This is the first case report to mention the use of NaF-18-PET/CT in the detection of bone metastasis from PRCC.Our case once again emphasizes the usefulness of NaF-18-PET/CT in RCC follow-up.

View Article: PubMed Central - PubMed

Affiliation: Department Radiology, Nuclear Medicine Section, UCSF, San Francisco, CA, USA.

ABSTRACT
We present a case of a 60-year-old white male with a history of papillary renal cell carcinoma (PRCC) status postpartial nepherectomy. He was followed-up annually with abdominal computed tomography (CT) scans to monitor for tumor recurrence. A solitary metastatic bony lesion was detected by CT 4 years after partial nephrectomy and it was confirmed by NaF-positron emission tomography (PET)/CT and magnetic resonance imaging. He underwent external beam radiation therapy (XRT) for solitary metastasis to L1 vertebra. The L1 lesion was treated with XRT, which exhibited no fluorodeoxyglucose activity after the treatment. This is the first case report to mention the use of NaF-18-PET/CT in the detection of bone metastasis from PRCC. Our case once again emphasizes the usefulness of NaF-18-PET/CT in RCC follow-up.

No MeSH data available.


Related in: MedlinePlus

FDG PET/CT images showing the recurrence of PRCC along the surgical margins after partial nephrectomy
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Figure 3: FDG PET/CT images showing the recurrence of PRCC along the surgical margins after partial nephrectomy

Mentions: Our patient is a 60-year-old white male with a history of hepatitis C infection and liver cirrhosis. RCC was diagnosed incidentally on abdominal CT ordered for liver cancer screening. He underwent subsequent partial nephrectomy in 2005. Surgical pathology report revealed PRCC Fuhrman Grade 3 (T1bN0M0). The patient was follow-up with annual CT exams. On a CT exam in 2009, a solitary sclerotic lesion was found on the L1 vertebra. A NaF-18-PET/CT whole body bone scan was ordered for further workup. The bone scan revealed increased osteoblastic activity in a single sclerotic lesion within the anterior L1 vertebral body with no other suspicious osseous lesions [Figure 1]. The patient had an additional magnetic resonance imaging (MRI) study to further rule out widespread metastasis. The MRI showed 2.3 × 1.2 enhancing lesion in the anterior third of the L1 vertebral body [Figure 2]. The case was presented to the tumor board and the decision was made to start external beam radiation therapy (XRT) to L1. The lesion remained stable on follow-up CT exams. An MRI study was performed in 2012 to monitor the lesion and it showed a lesion of mild heterogeneity at L1suggestive of fatty infiltration, which is a known consequence of radiation therapy [Figure 2]. An fluorodeoxyglucose (FDG)-PET/CT study with lasix protocol was performed in 2012 as a postradiation therapy follow-up. Increased FDG activity (SUVmax = 9.1) was seen along the suture lines and also in the soft tissue area in the right paraspinal region adjacent to a surgical clip [Figure 3]. There was no interval change in size for the sclerotic bone lesion at L1 and it did not show increased metabolic activity [Figure 4]. There were no physical symptoms or laboratory abnormalities at the time of the FDG-PET/CT study.


Use of NaF-18-Positron Emission Tomography/Computed Tomography in the Detection of Bone Metastasis from Papillary Renal Cell Carcinoma.

Aparici CM, Win AZ - World J Nucl Med (2014)

FDG PET/CT images showing the recurrence of PRCC along the surgical margins after partial nephrectomy
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4150157&req=5

Figure 3: FDG PET/CT images showing the recurrence of PRCC along the surgical margins after partial nephrectomy
Mentions: Our patient is a 60-year-old white male with a history of hepatitis C infection and liver cirrhosis. RCC was diagnosed incidentally on abdominal CT ordered for liver cancer screening. He underwent subsequent partial nephrectomy in 2005. Surgical pathology report revealed PRCC Fuhrman Grade 3 (T1bN0M0). The patient was follow-up with annual CT exams. On a CT exam in 2009, a solitary sclerotic lesion was found on the L1 vertebra. A NaF-18-PET/CT whole body bone scan was ordered for further workup. The bone scan revealed increased osteoblastic activity in a single sclerotic lesion within the anterior L1 vertebral body with no other suspicious osseous lesions [Figure 1]. The patient had an additional magnetic resonance imaging (MRI) study to further rule out widespread metastasis. The MRI showed 2.3 × 1.2 enhancing lesion in the anterior third of the L1 vertebral body [Figure 2]. The case was presented to the tumor board and the decision was made to start external beam radiation therapy (XRT) to L1. The lesion remained stable on follow-up CT exams. An MRI study was performed in 2012 to monitor the lesion and it showed a lesion of mild heterogeneity at L1suggestive of fatty infiltration, which is a known consequence of radiation therapy [Figure 2]. An fluorodeoxyglucose (FDG)-PET/CT study with lasix protocol was performed in 2012 as a postradiation therapy follow-up. Increased FDG activity (SUVmax = 9.1) was seen along the suture lines and also in the soft tissue area in the right paraspinal region adjacent to a surgical clip [Figure 3]. There was no interval change in size for the sclerotic bone lesion at L1 and it did not show increased metabolic activity [Figure 4]. There were no physical symptoms or laboratory abnormalities at the time of the FDG-PET/CT study.

Bottom Line: A solitary metastatic bony lesion was detected by CT 4 years after partial nephrectomy and it was confirmed by NaF-positron emission tomography (PET)/CT and magnetic resonance imaging.This is the first case report to mention the use of NaF-18-PET/CT in the detection of bone metastasis from PRCC.Our case once again emphasizes the usefulness of NaF-18-PET/CT in RCC follow-up.

View Article: PubMed Central - PubMed

Affiliation: Department Radiology, Nuclear Medicine Section, UCSF, San Francisco, CA, USA.

ABSTRACT
We present a case of a 60-year-old white male with a history of papillary renal cell carcinoma (PRCC) status postpartial nepherectomy. He was followed-up annually with abdominal computed tomography (CT) scans to monitor for tumor recurrence. A solitary metastatic bony lesion was detected by CT 4 years after partial nephrectomy and it was confirmed by NaF-positron emission tomography (PET)/CT and magnetic resonance imaging. He underwent external beam radiation therapy (XRT) for solitary metastasis to L1 vertebra. The L1 lesion was treated with XRT, which exhibited no fluorodeoxyglucose activity after the treatment. This is the first case report to mention the use of NaF-18-PET/CT in the detection of bone metastasis from PRCC. Our case once again emphasizes the usefulness of NaF-18-PET/CT in RCC follow-up.

No MeSH data available.


Related in: MedlinePlus