PET/CT for the diagnostic assessment of patients with renal cancer

Purpose: We discuss the current role of PET/CT in all phases of disease in RCC, potential advancements in the diagnostic and prognostic work up, including future perspectives regarding novel radiopharmaceuticals agents. Methods: A comprehensive search strategy was used based on SCOPUS and PubMed databases. From all studies published in English, we selected—for this Expert Review—the most relevant articles evaluating the use of PET/CT for the diagnostic assessment of patients with renal cancer. Results: The use of PET/CT in RCC is still very limited due to low sensitivity in some cases, fragmentary data, and scarce numerosity of clinical trials in this setting. However, new potential applications have been proposed for the staging and restaging process of RCC with potential prognostic role, as well new radiotracers for the evaluation of tumor proliferation, neoangiogenesis, and to assess the response to target therapies. Conclusion: In high-risk patients, 18F-FDG PET/CT may be useful for preoperative staging, in the restaging process and to monitor targeted molecular therapies such as tyrosine kinase inhibitors. A new scenario could be open for risk stratification assessment using 18F-FDG PET/CT. New radiopharmaceuticals agents have been proposed; however, further trials are warranted to establish their role in clinical setting.