PET/CT imaging of clear cell renal cell carcinoma with 124I labeled chimeric antibody

Abstract

Clear cell renal cell carcinoma (ccRCC) presents problems for urologists in diagnosis, treatment selection, intraoperative surgical margin analysis, and long term monitoring. In this paper we describe the development of a radiolabeled antibody specific to ccRCC (124I-cG250) and its potential to help urologists manage each of these problems. We believe 124I-cG250, in conjunction with perioperative Positron emission tomography/ computed tomography imaging and intraoperative handheld gamma probe use, has the potential to diagnose ccRCC, aid in determining a proper course of treatment (operative or otherwise), confirm complete resection of malignant tissue in real time, and monitor patients post-operatively.

Keywords

advanced kidney cancer kidney cancer basic research kidney cancer evaluation/staging kidney cancer localized kidney cancer

References

Brouwers, A.H. , Dorr, U. , Lang, O. , Boerman, O.C. , Oyen, W.J. , Steffens, M.G. et al. (2002) 131 I-Cg250 Monoclonal Antibody Immunoscintigraphy Versus [18 F]Fdg-Pet Imaging in Patients with Metastatic Renal Cell Carcinoma: A Comparative Study. Nucl Med Commun 23: 229-236.

Cohn, D.E. , Hall, N.C. , Povoski, S.P. , Seamon, L.G. , Farrar, W.B. and Martin Jr, E.W. (2008) Novel Perioperative Imaging with 18f-Fdg Pet/Ct and Intraoperative 18f-Fdg Detection Using a Handheld Gamma Probe in Recurrent Ovarian Cancer. Gynecol Oncol 110: 152-157.

Divgi, C.R. , Pandit-Taskar, N. , Jungbluth, A.A. , Reuter, V.E. , Gonen, M. , Ruan, S. et al. (2007) Preoperative Characterisation of Clear-Cell Renal Carcinoma Using Iodine-124-Labelled Antibody Chimeric G250 (124i-Cg250) and Pet in Patients with Renal Masses: A Phase I Trial. Lancet Oncol 8: 304-310.

Fergany, A.F. , Hafez, K.S. and Novick, A.C. (2000) Long-Term Results of Nephron Sparing Surgery for Localized Renal Cell Carcinoma: 10-Year Followup. J Urol 163: 442-445.

Fergany, A.F. , Saad, I.R. , Woo, L. and Novick, A.C. (2006) Open Partial Nephrectomy for Tumor in a Solitary Kidney: Experience with 400 Cases. J Urol 175: 1630-1633; discussion 1633.

Hall, N.C. , Povoski, S.P. , Murrey, D.A. , Knopp, M.V. and Martin, E.W. (2008) Bringing Advanced Medical Imaging into the Operative Arena Could Revolutionize the Surgical Care of Cancer Patients. Expert Rev Med Devices 5: 663-667.

Hall, N.C. , Povoski, S.P. , Murrey, D.A. , Knopp, M.V. and Martin Jr, E.W. (2007) Combined Approach of Perioperative 18f-Fdg Pet/Ct Imaging and Intraoperative 18f-Fdg Handheld Gamma Probe Detection for Tumor Localization and Verification of Complete Tumor Resection in Breast Cancer . World J Surg Oncol 5: 143.

Huang, W.C. , Elkin, E.B. , Levey, A.S. , Jang, T.L. and Russo, P. (2009) Partial Nephrectomy Versus Radical Nephrectomy in Patients with Small Renal Tumors-- Is There a Difference in Mortality and Cardiovascular Outcomes? J Urol 181: 55-61; discussion 61-52.

Kang, D.E. , White Jr, R.L. , Zuger, J.H. , Sasser, H.C. and Teigland, C.M. (2004) Clinical Use of Fluorodeoxyglucose F 18 Positron Emission Tomography for Detection of Renal Cell Carcinoma. J Urol 171: 1806-1809.

10.

Majhail, N.S. , Urbain, J.L. , Albani, J.M. , Kanvinde, M.H. , Rice, T.W. , Novick, A.C. et al. (2003) F-18 Fluorodeoxyglucose Positron Emission Tomography in the Evaluation of Distant Metastases from Renal Cell Carcinoma . J Clin Oncol 21: 3995-4000.

11.

Miyakita, H. , Tokunaga, M. , Onda, H. , Usui, Y. , Kinoshita, H. , Kawamura, N. et al. (2002) Significance of 18f-Fluorodeoxyglucose Positron Emission Tomography (Fdg-Pet) for Detection of Renal Cell Carcinoma and Immunohistochemical Glucose Transporter 1 (Glut-1) Expression in the Cancer. Int J Urol 9: 15-18.

12.

Oosterwijk, E. , Ruiter, D.J. , Hoedemaeker, P.J. , Pauwels, E.K. , Jonas, U. , Zwartendijk, J. et al. (1986a) Monoclonal Antibody G 250 Recognizes a Determinant Present in Renal-Cell Carcinoma and Absent from Normal Kidney . Int J Cancer 38: 489-494.

13.

Oosterwijk, E. , Ruiter, D.J. , Wakka, J.C. , Huiskens-Van Der Meij, J.W. , Jonas, U. , Fleuren, G.J. et al. (1986b) Immunohistochemical Analysis of Monoclonal Antibodies to Renal Antigens. Application in the Diagnosis of Renal Cell Carcinoma . Am J Pathol 123: 301-309.

14.

Povoski, S.P. , Hall, N.C. , Martin Jr, E.W. and Walker, M.J. (2008) Multimodality Approach of Perioperative 18f-Fdg Pet/Ct Imaging, Intraoperative 18f-Fdg Handheld Gamma Probe Detection, and Intraoperative Ultrasound for Tumor Localization and Verification of Resection of All Sites of Hypermetabolic Activity in a Case of Occult Recurrent Metastatic Melanoma. World J Surg Oncol 6: 1.

15.

Povoski, S.P. , Neff, R.L. , Mojzisik, C.M. , O'malley, D.M. , Hinkle, G.H. , Hall, N.C. et al. (2009) A Comprehensive Overview of Radioguided Surgery Using Gamma Detection Probe Technology. World J Surg Oncol 7: 11.

16.

Sarikaya, I. , Povoski, S.P. , Al-Saif, O.H. , Kocak, E. , Bloomston, M. , Marsh, S. et al. (2007) Combined Use of Preoperative 18f Fdg-Pet Imaging and Intraoperative Gamma Probe Detection for Accurate Assessment of Tumor Recurrence in Patients with Colorectal Cancer. World J Surg Oncol 5: 80.

17.

Steffens, M.G. , Boerman, O.C. , Oosterwijk-Wakka, J.C. , Oosterhof, G.O. , Witjes, J.A. , Koenders, E.B. et al. (1997) Targeting of Renal Cell Carcinoma with Iodine-131-Labeled Chimeric Monoclonal Antibody G250. J Clin Oncol 15: 1529-1537.