Based on the high expression of carbonic anhydrase IX (CAIX) in 95% of clear cell renal cell carcinoma (ccRCC), the anti-CAIX monoclonal antibody girentuximab can be used for the detection of ccRCC. This clinical study explores the value of 89Zr-labeled girentuximab positron emission tomography/computed tomography (PET/CT) imaging in diagnostic challenges regarding ccRCC. PET/CT imaging was performed 4 or 5 d after injection of 89Zr-girentuximab in patients with a primary renal mass (n=16) or a history of ccRCC (n=14). Scans were used for decision making (surgery/active surveillance) in case of indistinct renal masses. All resected PET-positive primary lesions proved to be ccRCC, while no lesion progression was seen in PET-negative masses. In patients suspected of recurrent/metastatic ccRCC, PET/CT with 89Zr-girentuximab was useful to confirm or exclude ccRCC, evaluate the extent of the disease, and differentiate from other cancers. In this group, 89Zr-girentuximab PET/CT resulted in a major change in clinical management in five patients (36%), while in three patients (21%) repeat biopsies could be avoided. We conclude that 89Zr-girentuximab PET/CT is a valuable diagnostic tool that can guide clinical decision making in case of diagnostic dilemmas concerning ccRCC suspicion.
Positron emission tomography/computed tomography imaging with 89Zr-girentuximab can be a valuable diagnostic tool to identify clear cell renal cell carcinoma.
European urology. 2018 May 02 [Epub ahead of print]
Marlène C H Hekman, Mark Rijpkema, Erik H Aarntzen, Sasja F Mulder, Johan F Langenhuijsen, Egbert Oosterwijk, Otto C Boerman, Wim J G Oyen, Peter F A Mulders
Department of Radiology and Nuclear Medicine, Radboudumc, Nijmegen, The Netherlands; Department of Urology, Radboudumc, Nijmegen, The Netherlands. Electronic address: ., Department of Radiology and Nuclear Medicine, Radboudumc, Nijmegen, The Netherlands., Department of Medical Oncology, Radboudumc, Nijmegen, The Netherlands., Department of Urology, Radboudumc, Nijmegen, The Netherlands., Department of Radiology and Nuclear Medicine, Radboudumc, Nijmegen, The Netherlands; The Institute of Cancer Research and The Royal Marsden Hospital, London, UK.