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Open Access Highly Accessed Research article

Impact of maximum Standardized Uptake Value (SUVmax) evaluated by 18-Fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (18F-FDG-PET/CT) on survival for patients with advanced renal cell carcinoma: a preliminary report

Kazuhiro Namura1, Ryogo Minamimoto2, Masahiro Yao15, Kazuhide Makiyama1, Takayuki Murakami1, Futoshi Sano1, Narihiko Hayashi1, Ukihide Tateishi2, Hanako Ishigaki3, Takeshi Kishida3, Takeshi Miura3, Kazuki Kobayashi4, Sumio Noguchi4, Tomio Inoue25, Yoshinobu Kubota15 and Noboru Nakaigawa15*

Author affiliations

1 Department of Urology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura kanazawaku Yokohama, 236-0004 Japan

2 Department of Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan

3 Department of Urology, Kanagawa Cancer Center, Yokohama, Japan

4 Department of Urology, Yokosuka Kyosai Hospital, Yokosuka, Japan

5 Advanced Medical Research Center, Yokohama City University, Yokohama, Japan

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Citation and License

BMC Cancer 2010, 10:667  doi:10.1186/1471-2407-10-667

Published: 3 December 2010

Abstract

Background

In this era of molecular targeting therapy when various systematic treatments can be selected, prognostic biomarkers are required for the purpose of risk-directed therapy selection. Numerous reports of various malignancies have revealed that 18-Fluoro-2-deoxy-D-glucose (18F-FDG) accumulation, as evaluated by positron emission tomography, can be used to predict the prognosis of patients. The purpose of this study was to evaluate the impact of the maximum standardized uptake value (SUVmax) from 18-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) on survival for patients with advanced renal cell carcinoma (RCC).

Methods

A total of 26 patients with advanced or metastatic RCC were enrolled in this study. The FDG uptake of all RCC lesions diagnosed by conventional CT was evaluated by 18F-FDG PET/CT. The impact of SUVmax on patient survival was analyzed prospectively.

Results

FDG uptake was detected in 230 of 243 lesions (94.7%) excluding lung or liver metastases with diameters of less than 1 cm. The SUVmax of 26 patients ranged between 1.4 and 16.6 (mean 8.8 ± 4.0). The patients with RCC tumors showing high SUVmax demonstrated poor prognosis (P = 0.005 hazard ratio 1.326, 95% CI 1.089-1.614). The survival between patients with SUVmax equal to the mean of SUVmax, 8.8 or more and patients with SUVmax less than 8.8 were statistically different (P = 0.0012). This is the first report to evaluate the impact of SUVmax on advanced RCC patient survival. However, the number of patients and the follow-up period were still not extensive enough to settle this important question conclusively.

Conclusions

The survival of patients with advanced RCC can be predicted by evaluating their SUVmax using 18F-FDG-PET/CT. 18F-FDG-PET/CT has potency as an "imaging biomarker" to provide helpful information for the clinical decision-making.