用于肾癌早期检测的新型成像方法.pdf

1、Novel Imaging Approaches for Early Detection of Kidney CancerMark W.Ball,MD FACSNovel Imaging Approaches for Early Detection of Kidney CancerMark W.Ball,MD FACSObjectives Describe lifetime risk of RCC and screening in Hereditary RCC syndromes Envision the Role for Novel Functional Imaging(PET,CA-IX)

2、in Screening and Management of Hereditary RCC syndromesHereditary Kidney CancerLinehan et al.Cancer Discov.2019 Aug;9(8):1006-1021Clear CellPapillary Type 1Papillary Type 2ChromophobeOncocytomaClear/ChromophobeHybridPapillary EpitheloidAngiomyolipomaEosinophilicMedullaryMESTVHL,TCEB1,BAP1METFLCNTSC1

3、,TSC2TFE3,TFEB,MITFSDHB,SDHC,SDHDPTENFHSMARCB1CDC73Lifetime RCC RiskSyndromeGene(s)RCC RiskScreening intervalVon Hippel-Lindau SyndromeVHL30-40%3 yearsHereditary Papillary Renal Cell CancerMET100%3 yearsBirt-Hogg-Dube SyndromeFLCN30%3 yearsHereditary Leiomyomatosis and Renal Cell CancerFH15-32%Annua

4、lAdapted from Ball&Shuch Current Opinion in Urology 29(4):p 334-343,July 2019.Growth rate correlates with genetic alterationsBall MW et al J Clin Oncol 2020,38:11435 tumors initially managed with ASRisk Adapted SurveillanceGomella PT et al Genes(Basel).2021 Feb 11;12(2):261Risk Adapted ScreeningGome

5、lla PT et al Genes(Basel).2021 Feb 11;12(2):261Leveraging MRI-VHLGopal N et al.Abdominal Radiology(2024)49:542550Leveraging MRI-HLRCCChaurasia A et al Abdominal Radiology(2023)48:340349Roles for Functional Imaging Characterize HLRCC localized and metastatic Differentiate tumors in BHDFunctional Imag

6、ing:FDG PETLoss of FH Increased aerobic glycolysis and flow of glucose carbons into the oxidative PPP Accumulation of oncometabolites fumarate and succinateLinehan et al Cancer Discov.2019;9(8):1006-1021.Functional Imaging:FDG PETNikpanah et al Abdominal Radio