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18F-FDG PET/CT for predicting inferior vena cava wall invasion in patients of renal cell carcinoma with the presence of inferior vena cava tumor thrombus
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18F-FDG PET/CT for predicting inferior vena cava wall invasion in patients of renal cell carcinoma with the presence of inferior vena cava tumor thrombus
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18F-FDG PET/CT for predicting inferior vena cava wall invasion in patients of renal cell carcinoma with the presence of inferior vena cava tumor thrombus
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Journal Article
18F-FDG PET/CT for predicting inferior vena cava wall invasion in patients of renal cell carcinoma with the presence of inferior vena cava tumor thrombus
2024
Overview
Introduction
Preoperative evaluation of inferior vena cava (IVC) wall invasion is very important to improve outcomes of patients with renal cell carcinoma (RCC), and may allow surgical urologists to treat the IVC more effectively. The objective of this study was to evaluate preoperative
18
F-FDG PET/CT in patients with RCC and IVC tumor thrombus (IVCTT) for the diagnosis of IVC wall invasion.
Methods
This retrospective case-control study evaluated 68 patients with RCC with level I-IV tumor thrombus. According to the histopathologic examination result, the patients were divided into IVC wall invasion group and non-invasion group. The
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F-FDG PET/CT features between two groups were analyzed. Furthermore, a logistic regression model was used to determine if there was an association between PET/CT features and IVC wall invasion.
Results
Sixty-eight patients were evaluated, and 55.9% (38/68) had IVC wall invasion. Compared with non-invasion group, invasion group had higher SUVmax of RCC, higher SURmax (tumor to tumor thrombus ratio, Tu/Th), higher IVCTT coronal diameter, and longer IVCTT craniocaudal extent (all
p
< 0.05). Multivariate analysis showed that SURmax (Tu/Th) (OR 8.760 [95%CI, 1.019–75.310];
p
= 0.048) and the maximum coronal diameter of IVCTT (OR 1.143 [95%CI, 1.029–1.269];
p
= 0.028) were predictors of IVC wall invasion. A model combining SURmax (Tu/Th) and the maximum coronal diameter of IVCTT achieved an AUC of 0.855 (95%CI, 0.757–0.954). The specificity and sensitivity for assessing IVC wall invasion was 92.1% and 76.7%, respectively.
Conclusions
Increases in SURmax (Tu/Th) and the maximum coronal diameter of IVCTT are associated with a higher probability of IVC wall invasion. Preoperative
18
F-FDG PET/CT imaging may be used to assess IVC wall invasion.
Publisher
BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
