You could be reading the full-text of this article now if you...

If you have access to this article through your institution,
you can view this article in

Diagnosis of Complex Renal Cystic Masses and Solid Renal Lesions Using PET Imaging: Comparison of 11C-Acetate and 18F-FDG PET Imaging

Oyama, Nobuyuki MD*; Ito, Hideaki MD*; Takahara, Noriko MD*; Miwa, Yoshiji MD*; Akino, Hironobu MD*; Kudo, Takashi MD†‡; Okazawa, Hidehiko MD; Fujibayashi, Yasuhisa PhD†§; Komatsu, Kazuto MD; Tsukahara, Kenji MD; Yokoyama, Osamu MD*

Clinical Nuclear Medicine:
doi: 10.1097/RLU.0000000000000287
Original Articles

Purpose: The study aims to assess the usefulness of PET with 11C-acetate and 18F-FDG to differentiate renal cell carcinoma (RCC) from complicated renal cysts.

Methods: Thirty-one patients were enrolled, 14 patients with complicated renal cysts (12 with Bosniak III and 2 with Bosniak IV) and 17 patients with 19 solid renal tumors. The patients underwent both 11C-acetate PET and FDG PET. Nephrectomy or partial nephrectomy was performed after the PET scans.

Results: In 29 patients, 32 renal lesions were diagnosed as RCC. Twenty-three of the 32 RCCs (72%) had positive 11C-acetate PET findings, whereas only 7 FDG PET studies were positive (22%). Considering the relationship between tumor size measured by macroscopic appearance of resected tumors and PET results, 22 of 25 (88%) tumors more than 1.5 cm showed positive 11C-acetate PET findings. In 12 patients with Bosniak III renal cysts, 10 renal lesions were diagnosed as RCC. In this subgroup, 5 of the 10 RCCs (50%) had positive 11C-acetate PET findings, whereas 2 RCCs (20%) had positive FDG PET findings. None of the cases with benign findings had positive 11C-acetate PET or FDG PET scans.

Conclusions: 11C-acetate PET demonstrates a pronounced increase in tracer uptake in RCC, especially in renal tumors more than 1.5 cm, and displays a higher sensitivity than FDG PET. These preliminary data show that 11C-acetate may be a useful PET tracer to exclude RCC in complex renal cysts.

Author Information

From the *Department of Urology, Faculty of Medical Sciences, and †Biomedical Imaging Research Center, University of Fukui, Fukui; ‡Department of Radioisotope Medicine, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki; §Molecular Imaging Center, National Institute of Radiological Sciences, Anagawa, Chiba; and ¶Department of Urology, Fukui Red Cross Hospital, Fukui, Japan.

Received for publication April 18, 2013; revision accepted September 19, 2013.

Conflicts of interest and sources of funding: The Grant-in-Aid for Scientific Research (C), 21st Century COE Program (Medical Science), The Japan Society for the Promotion of Science.

Reprints: Nobuyuki Oyama, MD, Department of Urology, University of Fukui, 23-3 Matsuoka-Shimoaizuki. Eiheiji, Fukui 9101193, Japan. E-mail:

© 2014 by Lippincott Williams & Wilkins