Opinion

Video

Key Benefits of PET in ccRCC Risk Stratification

Panelists discuss how PET imaging for kidney cancer includes prostate-specific membrane antigen, which is sometimes expressed in renal cell carcinoma, though its utility remains unclear, whereas fluorodeoxyglucose PET can be useful for metabolic activity assessment despite limitations with inflammatory lesions.

PET Imaging in Kidney Cancer Evaluation

Main Discussion Topics:

  • Prostate-specific membrane antigen (PSMA) expression in renal cell carcinoma (RCC) was an incidental finding but shows potential.
  • Uncertainty regarding frequency of PSMA expression across RCC subtypes
  • Fluorodeoxyglucose (FDG) PET has limited utility in most RCC cases but may help characterize indeterminate lymph nodes or lung lesions.
  • FDG PET shows particular value in rare FH-deficient tumors, which demonstrate intense uptake.

Key Points for Physicians:

  • PSMA PET shows promise but lacks sufficient data for routine clinical use.
  • FDG PET has limited utility in conventional RCC.
  • FDG PET demonstrates high value in rare hereditary RCC variants with SDH or FH mutations.
  • Current molecular imaging techniques provide adjunctive rather than primary diagnostic value.

Notable Insights:

Although molecular imaging shows promise, current modalities have significant limitations and are primarily useful in specific clinical scenarios.

Clinical Significance:

Molecular imaging techniques remain investigational for most RCC applications but show the potential to transform staging and characterization

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