Korean J Radiol.  2013 Apr;14(2):337-342. 10.3348/kjr.2013.14.2.337.

FDG PET or PET/CT in Evaluation of Renal Angiomyolipoma

• Lin CY
• Chen HY
• Ding HJ
• Yen KY
• Kao CH

• KMID: 1482797
• DOI: http://doi.org/10.3348/kjr.2013.14.2.337

Abstract

OBJECTIVE
Angiomyolipoma is the most common benign kidney tumor. However, literature describing FDG PET findings on renal angiomyolipoma (AML) is limited. This study reports the FDG PET and PET/CT findings of 21 cases of renal AML.
MATERIALS AND METHODS
The study reviews FDG PET and PET/CT images of 21 patients diagnosed with renal AML. The diagnosis is based on the classical appearance of an AML on CT scan with active surveillance for 6 months. The study is focused on the observation of clinical and radiographic features.
RESULTS
Six men and 15 women were included in our study. The mean age of the patients was 57.14 +/- 9.67 years old. The mean diameter of 21 renal AML on CT scans was 1.76 +/- 1.00 cm (Min: 0.6 cm; Max: 4.4 cm). CT scans illustrated renal masses typical of AMLs, and the corresponding FDG PET scans showed minimal FDG activities in the area of the tumors. None of the 21 AMLs showed a maximum standardized uptake value (SUVmax) greater than 1.98. No statistically significant correlation was present between SUVmax and tumor size.
CONCLUSION
Renal AMLs demonstrate very low to low uptake on FDG PET and PET/CT imaging in this study. When a fat-containing tumor in the kidney is found on a CT scan, it is critical to differentiate an AML from a malignant tumor including an RCC, liposarcoma, and Wilms tumor. This study suggests that FDG PET or PET/CT imaging is useful for differentiating a renal AML from a fat-containing malignant tumor.

Keyword

Computed tomography; Fluorine-18 fluoro-2-deoxy-D-glucose; Positron emission tomography; Renal angiomylipoma

MeSH Terms

Angiomyolipoma/*radionuclide imaging
Contrast Media/diagnostic use
Ehlers-Danlos Syndrome
Female
Fluorodeoxyglucose F18/diagnostic use
Humans
Kidney Neoplasms/*radionuclide imaging
Male
Middle Aged
*Positron-Emission Tomography
*Positron-Emission Tomography and Computed Tomography
Radiopharmaceuticals/diagnostic use
Retrospective Studies
Contrast Media
Radiopharmaceuticals
Fluorodeoxyglucose F18

Figure

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  Fig. 1 58-year-old hepatoma male patient with liver cirrhosis with massive ascites and angiomyolipoma (AML) in left kidney received whole body FDG PET/CT for detecting extrahepatic metastases (patient no. 10 in Table 1). Uptake of 18F-FDG in renal AML was lower than that of spine (arrows).

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  Fig. 2 59-year-old female patient with angiomyolipoma (AML) in right kidney (patient no. 19 in Table 1). Uptake of 18F-FDG in renal AML was higher than that of spine but lower than hepatic activity (arrows).

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  Fig. 3 30-year-old male with renal cell carcinoma in right kidney (arrows). Maximum standardized uptake value on FDG PET is 5.43.

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  Fig. 4 58-year-old male with renal cell carcinoma in right kidney (arrows). Maximum standardized uptake value on FDG PET is 1.88.

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