Indium-111-labeled Girentuximab ImmunoSPECT as a Diagnostic Tool in Clear Cell Renal Cell Carcinoma
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Abstract
Background: Improved and more frequent radiologic evaluation has resulted in increased identification of renal masses of unknown origin, which frequently pose a diagnostic dilemma for urologists. Objective: Carbonic anhydrase IX (CAIX) is an antigen ubiquitously expressed in clear cell renal cell carcinoma (ccRCC). The specific and high level of expression in ccRCC makes CAIX an excellent target for imaging ccRCC lesions. We present our experience with immuno-single-photon emission computed tomography (immunoSPECT) imaging with the indium-111 (111In)-labeled anti-CAIX antibody girentuximab in patients presenting with either a primary renal tumor or a history of ccRCC and lesions suspect for metastases during follow-up. Design, setting, and participants: Twenty-nine patients received 100-200 MBq 111In-labeled girentuximab. Whole-body and single photon emission computed tomography (SPECT) images were acquired after 4-7 d. Intervention: Injection with 111In-girentuximab and image acquisition after 4-7 d. Outcome measurements and statistical analysis: Accuracy of 111In-girentuximab immunoSPECT. Results and limitations: Distinct uptake of 111In-girentuximab was seen in 16 of 22 patients presenting with a renal mass. All renal masses proven to be ccRCC after resection (n = 15) were detected with 111In-girentuximab. Suspect lesions of six patients showed no uptake of 111In-girentuximab. In these patients, ccRCC was not found, nor progression occurred. Seven patients with a history of ccRCC and possible metastatic lesions on follow-up computed tomography scans were imaged with 111In-girentuximab. In four of these patients, the lesions showed preferential uptake of 111In-girentuximab and local or systemic treatment was initiated. In three other cases, no 111In-girentuximab targeting was seen. During follow-up of these three patients, one showed progression, for which systemic treatment was started. In the two other patients, no progression occurred, suggesting a benign nature. Conclusions: 111In-girentuximab immunoSPECT can be used to detect ccRCC lesions in patients with a primary renal mass and to clarify the nature of lesions suspect for metastases in patients with a history of ccRCC.
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en" level="a">Indium-111-labeled Girentuximab ImmunoSPECT as a Diagnostic Tool in Clear Cell Renal Cell Carcinoma</title><author><name sortKey="Muselaers, Constantijn H J" uniqKey="Muselaers C">Constantijn H. J. Muselaers</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Urology, Radboud University Nijmegen Medical Centre</s1><s2>Nijmegen</s2><s3>NLD</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Pays-Bas</country><wicri:noRegion>Nijmegen</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Nuclear Medicine, Radboud University Nijmegen Medical Centre</s1><s2>Nijmegen</s2><s3>NLD</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Pays-Bas</country><wicri:noRegion>Nijmegen</wicri:noRegion></affiliation></author><author><name sortKey="Boerman, Otto C" uniqKey="Boerman O">Otto C. Boerman</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Nuclear Medicine, Radboud University Nijmegen Medical Centre</s1><s2>Nijmegen</s2><s3>NLD</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Pays-Bas</country><wicri:noRegion>Nijmegen</wicri:noRegion></affiliation></author><author><name sortKey="Oosterwijk, Egbert" uniqKey="Oosterwijk E">Egbert Oosterwijk</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Urology, Radboud University Nijmegen Medical Centre</s1><s2>Nijmegen</s2><s3>NLD</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Pays-Bas</country><wicri:noRegion>Nijmegen</wicri:noRegion></affiliation></author><author><name sortKey="Langenhuijsen, Johannes F" uniqKey="Langenhuijsen J">Johannes F. Langenhuijsen</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Urology, Radboud University Nijmegen Medical Centre</s1><s2>Nijmegen</s2><s3>NLD</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Pays-Bas</country><wicri:noRegion>Nijmegen</wicri:noRegion></affiliation></author><author><name sortKey="Oyen, Wim J G" uniqKey="Oyen W">Wim J. G. Oyen</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Nuclear Medicine, Radboud University Nijmegen Medical Centre</s1><s2>Nijmegen</s2><s3>NLD</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Pays-Bas</country><wicri:noRegion>Nijmegen</wicri:noRegion></affiliation></author><author><name sortKey="Mulders, Peter F A" uniqKey="Mulders P">Peter F. A. Mulders</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Urology, Radboud University Nijmegen Medical Centre</s1><s2>Nijmegen</s2><s3>NLD</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Pays-Bas</country><wicri:noRegion>Nijmegen</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="inist">13-0177006</idno><date when="2013">2013</date><idno type="stanalyst">PASCAL 13-0177006 INIST</idno><idno type="RBID">Pascal:13-0177006</idno><idno type="wicri:Area/Main/Corpus">000E26</idno><idno type="wicri:Area/Main/Repository">000A74</idno></publicationStmt><seriesStmt><idno type="ISSN">0302-2838</idno><title level="j" type="abbreviated">Eur. urol.</title><title level="j" type="main">European urology</title></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Chimerism</term><term>Clear cell carcinoma</term><term>Diagnosis</term><term>Grawitz tumor</term><term>Indium</term><term>Kidney</term><term>Kidney cancer</term><term>Mesonephroma</term><term>Monoclonal antibody</term><term>Nephrology</term><term>Urology</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Cancer rein</term><term>Indium</term><term>Diagnostic</term><term>Carcinome cellule claire</term><term>Mésonéphrome</term><term>Hypernéphrome</term><term>Chimérisme</term><term>Anticorps monoclonal</term><term>Rein</term><term>Néphrologie</term><term>Urologie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background: Improved and more frequent radiologic evaluation has resulted in increased identification of renal masses of unknown origin, which frequently pose a diagnostic dilemma for urologists. Objective: Carbonic anhydrase IX (CAIX) is an antigen ubiquitously expressed in clear cell renal cell carcinoma (ccRCC). The specific and high level of expression in ccRCC makes CAIX an excellent target for imaging ccRCC lesions. We present our experience with immuno-single-photon emission computed tomography (immunoSPECT) imaging with the indium-111 (<sup>111</sup>In)-labeled anti-CAIX antibody girentuximab in patients presenting with either a primary renal tumor or a history of ccRCC and lesions suspect for metastases during follow-up. Design, setting, and participants: Twenty-nine patients received 100-200 MBq <sup>111</sup>In-labeled girentuximab. Whole-body and single photon emission computed tomography (SPECT) images were acquired after 4-7 d. Intervention: Injection with <sup>111</sup>In-girentuximab and image acquisition after 4-7 d. Outcome measurements and statistical analysis: Accuracy of <sup>111</sup>In-girentuximab immunoSPECT. Results and limitations: Distinct uptake of <sup>111</sup>In-girentuximab was seen in 16 of 22 patients presenting with a renal mass. All renal masses proven to be ccRCC after resection (n = 15) were detected with <sup>111</sup>In-girentuximab. Suspect lesions of six patients showed no uptake of <sup>111</sup>In-girentuximab. In these patients, ccRCC was not found, nor progression occurred. Seven patients with a history of ccRCC and possible metastatic lesions on follow-up computed tomography scans were imaged with <sup>111</sup>In-girentuximab. In four of these patients, the lesions showed preferential uptake of <sup>111</sup>In-girentuximab and local or systemic treatment was initiated. In three other cases, no <sup>111</sup>In-girentuximab targeting was seen. During follow-up of these three patients, one showed progression, for which systemic treatment was started. In the two other patients, no progression occurred, suggesting a benign nature. Conclusions: <sup>111</sup>In-girentuximab immunoSPECT can be used to detect ccRCC lesions in patients with a primary renal mass and to clarify the nature of lesions suspect for metastases in patients with a history of ccRCC.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0302-2838</s0></fA01><fA02 i1="01"><s0>EUURAV</s0></fA02><fA03 i2="1"><s0>Eur. urol.</s0></fA03><fA05><s2>63</s2></fA05><fA06><s2>6</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Indium-111-labeled Girentuximab ImmunoSPECT as a Diagnostic Tool in Clear Cell Renal Cell Carcinoma</s1></fA08><fA11 i1="01" i2="1"><s1>MUSELAERS (Constantijn H. J.)</s1></fA11><fA11 i1="02" i2="1"><s1>BOERMAN (Otto C.)</s1></fA11><fA11 i1="03" i2="1"><s1>OOSTERWIJK (Egbert)</s1></fA11><fA11 i1="04" i2="1"><s1>LANGENHUIJSEN (Johannes F.)</s1></fA11><fA11 i1="05" i2="1"><s1>OYEN (Wim J. G.)</s1></fA11><fA11 i1="06" i2="1"><s1>MULDERS (Peter F. A.)</s1></fA11><fA14 i1="01"><s1>Department of Urology, Radboud University Nijmegen Medical Centre</s1><s2>Nijmegen</s2><s3>NLD</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>6 aut.</sZ></fA14><fA14 i1="02"><s1>Department of Nuclear Medicine, Radboud University Nijmegen Medical Centre</s1><s2>Nijmegen</s2><s3>NLD</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ></fA14><fA20><s1>1101-1106</s1></fA20><fA21><s1>2013</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>16847</s2><s5>354000504121710180</s5></fA43><fA44><s0>0000</s0><s1>© 2013 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>23 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>13-0177006</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>European urology</s0></fA64><fA66 i1="01"><s0>GBR</s0></fA66><fC01 i1="01" l="ENG"><s0>Background: Improved and more frequent radiologic evaluation has resulted in increased identification of renal masses of unknown origin, which frequently pose a diagnostic dilemma for urologists. Objective: Carbonic anhydrase IX (CAIX) is an antigen ubiquitously expressed in clear cell renal cell carcinoma (ccRCC). The specific and high level of expression in ccRCC makes CAIX an excellent target for imaging ccRCC lesions. We present our experience with immuno-single-photon emission computed tomography (immunoSPECT) imaging with the indium-111 (<sup>111</sup>In)-labeled anti-CAIX antibody girentuximab in patients presenting with either a primary renal tumor or a history of ccRCC and lesions suspect for metastases during follow-up. Design, setting, and participants: Twenty-nine patients received 100-200 MBq <sup>111</sup>In-labeled girentuximab. Whole-body and single photon emission computed tomography (SPECT) images were acquired after 4-7 d. Intervention: Injection with <sup>111</sup>In-girentuximab and image acquisition after 4-7 d. Outcome measurements and statistical analysis: Accuracy of <sup>111</sup>In-girentuximab immunoSPECT. Results and limitations: Distinct uptake of <sup>111</sup>In-girentuximab was seen in 16 of 22 patients presenting with a renal mass. All renal masses proven to be ccRCC after resection (n = 15) were detected with <sup>111</sup>In-girentuximab. Suspect lesions of six patients showed no uptake of <sup>111</sup>In-girentuximab. In these patients, ccRCC was not found, nor progression occurred. Seven patients with a history of ccRCC and possible metastatic lesions on follow-up computed tomography scans were imaged with <sup>111</sup>In-girentuximab. In four of these patients, the lesions showed preferential uptake of <sup>111</sup>In-girentuximab and local or systemic treatment was initiated. In three other cases, no <sup>111</sup>In-girentuximab targeting was seen. During follow-up of these three patients, one showed progression, for which systemic treatment was started. In the two other patients, no progression occurred, suggesting a benign nature. Conclusions: <sup>111</sup>In-girentuximab immunoSPECT can be used to detect ccRCC lesions in patients with a primary renal mass and to clarify the nature of lesions suspect for metastases in patients with a history of ccRCC.</s0></fC01><fC02 i1="01" i2="X"><s0>002B14D01</s0></fC02><fC02 i1="02" i2="X"><s0>002B04C</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Cancer rein</s0><s2>NM</s2><s5>01</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Kidney cancer</s0><s2>NM</s2><s5>01</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Cáncer del riñón</s0><s2>NM</s2><s5>01</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Indium</s0><s2>NC</s2><s5>02</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Indium</s0><s2>NC</s2><s5>02</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Indio</s0><s2>NC</s2><s5>02</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Diagnostic</s0><s5>03</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Diagnosis</s0><s5>03</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Diagnóstico</s0><s5>03</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Carcinome cellule claire</s0><s5>05</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Clear cell carcinoma</s0><s5>05</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Carcinoma célula clara</s0><s5>05</s5></fC03><fC03 i1="05" i2="X" l="FRE"><s0>Mésonéphrome</s0><s5>06</s5></fC03><fC03 i1="05" i2="X" l="ENG"><s0>Mesonephroma</s0><s5>06</s5></fC03><fC03 i1="05" i2="X" l="SPA"><s0>Mesonefroma</s0><s5>06</s5></fC03><fC03 i1="06" i2="X" l="FRE"><s0>Hypernéphrome</s0><s5>08</s5></fC03><fC03 i1="06" i2="X" l="ENG"><s0>Grawitz tumor</s0><s5>08</s5></fC03><fC03 i1="06" i2="X" l="SPA"><s0>Hipernefroma</s0><s5>08</s5></fC03><fC03 i1="07" i2="X" l="FRE"><s0>Chimérisme</s0><s5>09</s5></fC03><fC03 i1="07" i2="X" l="ENG"><s0>Chimerism</s0><s5>09</s5></fC03><fC03 i1="07" i2="X" l="SPA"><s0>Quimerismo</s0><s5>09</s5></fC03><fC03 i1="08" i2="X" l="FRE"><s0>Anticorps monoclonal</s0><s5>11</s5></fC03><fC03 i1="08" i2="X" l="ENG"><s0>Monoclonal antibody</s0><s5>11</s5></fC03><fC03 i1="08" i2="X" l="SPA"><s0>Anticuerpo monoclonal</s0><s5>11</s5></fC03><fC03 i1="09" i2="X" l="FRE"><s0>Rein</s0><s5>12</s5></fC03><fC03 i1="09" i2="X" l="ENG"><s0>Kidney</s0><s5>12</s5></fC03><fC03 i1="09" i2="X" l="SPA"><s0>Riñón</s0><s5>12</s5></fC03><fC03 i1="10" i2="X" l="FRE"><s0>Néphrologie</s0><s5>17</s5></fC03><fC03 i1="10" i2="X" l="ENG"><s0>Nephrology</s0><s5>17</s5></fC03><fC03 i1="10" i2="X" l="SPA"><s0>Nefrología</s0><s5>17</s5></fC03><fC03 i1="11" i2="X" l="FRE"><s0>Urologie</s0><s5>18</s5></fC03><fC03 i1="11" i2="X" l="ENG"><s0>Urology</s0><s5>18</s5></fC03><fC03 i1="11" i2="X" l="SPA"><s0>Urología</s0><s5>18</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Tumeur maligne</s0><s2>NM</s2><s5>37</s5></fC07><fC07 i1="01" i2="X" l="ENG"><s0>Malignant tumor</s0><s2>NM</s2><s5>37</s5></fC07><fC07 i1="01" i2="X" l="SPA"><s0>Tumor maligno</s0><s2>NM</s2><s5>37</s5></fC07><fC07 i1="02" i2="X" l="FRE"><s0>Cancer</s0><s2>NM</s2></fC07><fC07 i1="02" i2="X" l="ENG"><s0>Cancer</s0><s2>NM</s2></fC07><fC07 i1="02" i2="X" l="SPA"><s0>Cáncer</s0><s2>NM</s2></fC07><fC07 i1="03" i2="X" l="FRE"><s0>Pathologie de l'appareil urinaire</s0><s5>38</s5></fC07><fC07 i1="03" i2="X" l="ENG"><s0>Urinary system disease</s0><s5>38</s5></fC07><fC07 i1="03" i2="X" l="SPA"><s0>Aparato urinario patología</s0><s5>38</s5></fC07><fC07 i1="04" i2="X" l="FRE"><s0>Pathologie du rein</s0><s5>39</s5></fC07><fC07 i1="04" i2="X" l="ENG"><s0>Kidney disease</s0><s5>39</s5></fC07><fC07 i1="04" i2="X" l="SPA"><s0>Riñón patología</s0><s5>39</s5></fC07><fC07 i1="05" i2="X" l="FRE"><s0>Appareil urinaire</s0><s5>40</s5></fC07><fC07 i1="05" i2="X" l="ENG"><s0>Urinary system</s0><s5>40</s5></fC07><fC07 i1="05" i2="X" l="SPA"><s0>Aparato urinario</s0><s5>40</s5></fC07><fN21><s1>154</s1></fN21><fN44 i1="01"><s1>OTO</s1></fN44><fN82><s1>OTO</s1></fN82></pA></standard></inist></record>Pour manipuler ce document sous Unix (Dilib)
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