Role of (18)F-FDG PET/CT for detection of recurrence and metastases in renal cell carcinoma—are we underusing PET/CT?

PURPOSE: The aim of this study was to compare (18)F-fluorodeoxyglucose positron emission tomography–computed tomography ((18)F-FDG PET/CT) scan with computed tomography (CT) scan for detecting recurrence and metastasis in renal cell carcinoma patients. METHODS: This retrospective study included patients from October 2013 to April 2017. Contrast-enhanced CT and PET/CT scans were compared and correlated with histopathology or/and follow-up studies. RESULTS: Seventy-six patients, 60 males, were included. Lesions included primary renal, recurrent renal fossa lesions, lymph nodes, and distant metastatic lesions. Of 176 malignant lesions, CT detected 157 lesions; of which, 154 were true positive. Twenty-two false-negative lesions showed abnormal FDG uptake. CT scan had positive predictive value (PPV), negative predictive value (NPV), sensitivity, specificity, and accuracy of 98.0%, 37.1%, 87.5%, 81.2%, and 86.9%, respectively. All 176 lesions were PET/CT-positive. PET/CT had PPV, NPV, sensitivity, specificity, and accuracy of 100% each. The specificity and NPV of PET/CT were superior (P < .05). CONCLUSION: PET/CT appears more accurate than CT scan for detecting metastasis and recurrence in renal cell carcinoma patients.