Dynamic 82-Rb Positron Emission Tomography (PET) for the Grading of KIDney Carcinoma

Tumoral vascularization is an important prognostic marker in renal cell carcinomas (RCC). The evaluation of RCC is often complex before surgery as only a small peripheral segment of the tumor is obtained with biopsy and tend to underestimate the aggressiveness and grade of RCC. Accurate noninvasive evaluation of the aggressiveness of RCC could improve the characterization of tumors before surgery and help guide patient management. Radiolabeled water has demonstrated its interest for the quantification of the vascularization of renal tumors in Positron Emission Tomography (PET). The synthesis of radiolabeled water requires, however, an on-site cyclotron, which is available only in a limited number of hospitals. 82-Rb, a potassium analog and positron-emitting radiotracer, is taken up by myocardial and renal cells. 82-Rb has been used for more than 15 years in North America for the quantification of myocardial perfusion with PET. The solution of 82-Rb chloride is obtained from 82-Sr / 82-Rb radiopharmaceutical generators which have recently obtained a marketing authorization in Europe. These generators can be installed in nuclear medicine departments in hospitals. Myocardial perfusion flow can be precisely quantified by modelling tissue uptake of the tracer on dynamic acquisitions obtained during the intravenous administration of 82-Rb chloride. Our hypothesis is that 82-Rb uptake profile could help grade noninvasively the aggressiveness of renal tumors.

• Correlation between the renal perfusion flow and the degree of neoangiogenesis in the tumor. [Срок оценки: Up to three months after surgery]
• Association between imaging biomarkers on 82-Rb-PET and the histological type of the tumor. [Срок оценки: Up to three months after surgery]
• Association between imaging biomarkers on 82-Rb-PET and tumor aggressiveness (ISUP grades) in patients with clear-cell renal adenocarcinomas. [Срок оценки: Up to three months after surgery]
• Correlation between 82-Rb uptake and the degree of neoangiogenesis in the tumor. [Срок оценки: Up to three months after surgery]
• Correlation between the estimated residual renal function and the observed renal function change. [Срок оценки: Up to three months after surgery]
• To compare the diagnostic performance of biopsy and 82-Rb-PET for the ISUP grading of clear cell renal adenocarcinomas against the final results of histology (gold standard) of the renal tumor. [Срок оценки: Up to three months after surgery]
• Safety and tolerance of 82-Rb [Срок оценки: Up to 72 hours after the PET with injection of the radiopharmaceutical]