Table 1.
Summary of PSMA PET/CT studies in RCC patients
| Authors | Number of patients | PSMA-ligand | Study type | Setting | Histology | Comments |
|---|---|---|---|---|---|---|
| Marafi et al. (2020) | 1 | 18F-PSMA-1007 | Case report | Staging | ccRCC | 18F-PSMA-1007 PET/CT showed intense of primary renal tumor and bilateral lung nodules |
| Sawicki et al. (2017) | 6 | 68Ga-PSMA-11 | Retrospective | Staging | 4 ccRCC, 1pRCC, 1 chrRCC | 5/6 primary RCC showed PSMA uptake but TBR-SUVmax was low. 8/16 metastases were PSMA positive with a high MBR-SUVmax. All PSMA negative metastasis were subcentimetric lung nodules |
| Raveenthiran et al. (2019) | 38 | 68Ga-PSMA-11 | Retrospective | Staging and Restaging | Staging: 8 ccRCC, 1 pRCC, 1 oncocytoma, 6 unknown; Restaging: 20 ccRCC, 1 chrRCC, 1 transitional cell carcinoma | Staging: 16 patients enrolled. 75% showed primary avid lesions. Management was changed for the 43.8%. PSMA PET/CT and ceCT agreed only in the 37.5%. Restaging: 22 patients enrolled. Management was changed in 40.9%. PSMA PET/CT and ceCT agreed only in the 36.4%. Management was changed due to the identification of new sites of suspected metastasis and/or detection of synchronous primaries |
| Siva et al. (2017) | 8 | 68Ga-PSMA-11, 18F-FDG | Retrospective | Staging and therapy response evaluation | 7 ccRCC, 1 pRCC | PSMA uptake is typically more intense than FDG in RCC. The 2 radiotracers are concordant for detection of sites of disease except in 2 cases (1 of which was papillary carcinoma). 18F-FDG PET demonstrated a more rapid response to treatment, but both PET/CT demonstrated responses earlier than the conventional imaging |
| Tariq et al. (2021) | 11 | 68Ga-PSMA-11, 18F-FDG | Retrospective | Staging and Restaging | 10 ccRCC, 1 unclassified | For primary tumor assessment, 68Ga-PSMA-11 and 18F-FDG were concordant in 2 patients, and discordant in 3. For metastatic disease, dual tracers were concordant in 9/11 patients. In 3 patients, change was determined a change in clinical management |
| Saadat et al. (2018) | 1 | Not reported | Case report | Staging mRCC | ccRCC | 18F-FDG seems superior to PSMA PET/CT in detecting RCC associated tumor thrombus |
| Rhee et al. (2016) | 10 | 68Ga-PSMA-11 | Prospective | Staging | 8 ccRCC, 1pRCC, 1 unclassified RCC | PSMA PET/CT detected multiple histologically proven RCC metastases undetected by ceCT, changing patient’s management |
| Gao et al. (2020) | 36 | 68Ga-PSMA-11 | Retrospective | Pre-operative | ccRCC | SUVmax could differentiate WHO/ISUP grade (3–4 vs. 1–2), pT stage and adverse pathology (benign vs. malign) with a cut-off value of 16.4 |
| Golan et al. (2021) | 27 | 68Ga-PSMA-11 | Prospective | Pre-operative | 18 ccRCC, 4 pRCC, 2 chrRCC, 2 Oncocytoma, 2 Angiomyolipoma, 1 Mixed Epithelial and Stromal Tumor | 29 renal masses were evaluated. Malignant masses (24/29) had median SUVmean and SUVmax significantly higher than benign, a lower wash-out coefficient (K2) and were associated with a positive PSMA staining (20/24) |
| Rowe et al. (2015) | 5 | 18F-DCFPyL | Prospective | Recurrency | ccRCC | Sites of putative metastatic disease were readily identifiable by abnormal 18F-PSMA uptake in each of the 5 patients studied, with overall more lesions detected than on the conventional imaging |
| Yin et al. (2019) | 8 | 18F-DCFPyL | Prospective | Staging/Restaging | nccRCC: 3 pRCC, 2 chrRCC, 2 unclassified RCC, 1 Xp11 traslocation RCC | PSMA PET/CT seems not appropriate to image nccRCC |
| Meyer et al. (2019) | 14 | 18F-DCFPyL | Prospective | Restaging | ccRCC | 17/21 (81.0%) metastatic lesions detected on the conventional imaging had radiotracer uptake. 3/3 primary ccRCC had PSMA uptake. In 4 (28.6%) patients, 12 more lesions were identified on PSMA PET/CT than the conventional imaging and 3 of those were no longer considered oligometastatic |
| Guhne et al. (2021) | 9 | 68Ga-PSMA-11 | Retrospective | Recurrency | ccRCC | Among 12 PSMA-positive lesions evaluated, 11 were ccRCC metastases and 1 prostate carcinoma at histology. Molecular PSMA expression was detected in all lesions, but intensity and distribution did not correlate with PET parameters (particularly in small lung nodules) |
| Mittlmeier et al. (2021) | 11 | 18F-PSMA-1007 | Prospective | Therapy response evaluation | ccRCC | Highly diverging results emerged between PSMA PET/CT and ceCT therapy response evaluation. PSMA PET/CT might allow more precise response assessment to systematic treatment especially for patients showing SD at ceCT |
| Seront et al. (2021) | 2 | 68Ga-PSMA-11 | Retrospective | Therapy response evaluation | ccRCC | 68Ga-PSMA-PET is a promising imaging for early prediction of response to systemic treatment in ccRCC |
18F-FDG 18F-Fluorodeoxyglucose, ccRCC clear cell Renal Cell Carcinoma, ceCT contrast-enhanced computed tomography, chrRCC chromophobe Renal Cell Carcinoma, MBR metastasis-to-background, mRCC metastatic Renal Cell Carcinoma, nccRCC non-clear cell Renal Cell Carcinoma, PET/CT positron emission tomography/computed tomography, pRCC papillary Renal Cell Carcinoma, PSMA prostate-specific membrane antigen, RCC Renal Cell Carcinoma, SD stable disease, TBR tumor-to-background ratio