Multimodal Imaging and Detection Strategy With 124 I-Labeled Chimeric\nMonoclonal Antibody cG250 for Accurate Localization and Confirmation of Extent of Disease\nDuring Laparoscopic and Open Surgical Resection of Clear Cell Renal Cell\nCarcinoma
A 39-year-old Caucasian female with a previous history of renal calculi presented for\nevaluation of right flank pain. Ultrasound of the abdomen showed a 1.9 cm × 1.6 cm × 1.4 cm\nsolid-appearing lesion in the inferior pole of the right kidney. CT of the abdomen showed a\n2.0 cm × 1.9 cm × 1.9 cm intraparenchymal mass within the posterior cortex of the inferior\npole of the right kidney ().\n124I-cG250 PET/CT imaging was performed 5 days following intravenous\nadministration of 5.2 mCi of 124I-cG250 (). 124I PET/CT imaging showed\nincreased 124I-cG250 activity within the renal mass in the inferior pole of the\nright kidney.\nThe patient was taken to the operating room and underwent an open right partial nephrectomy\nof the inferior pole of the right kidney. At the discretion of the surgeon, an\nintraoperative gamma detection probe was not used in this case.\nThe intact and bisected right partial nephrectomy specimens were imaged with\n124I PET/CT imaging (). 124I-cG250 PET/CT imaging clearly identified the tumor size and\nlocation within the intact and bisected specimens and the relationship of the tumor to the\nparenchymal surgical resection margin surface within the bisected specimen.\nThe right partial nephrectomy specimen underwent subsequent standard pathology processing\nand microscopic evaluation (). Histopathologic evaluation of the right partial nephrectomy specimen revealed an\nRCC (Fuhrman grade 2, 1.7 cm × 1.5 cm × 1.4 cm) of the clear cell type. It had negative\nsurgical resection margins, with the closest distance measuring 0.7 cm from the inked\nparenchymal surgical resection margin surface of the right partial nephrectomy specimen,\nwhich correlated well with the 124I-cG250 PET/CT image of the bisected right\npartial nephrectomy specimen.\nThe patient had a relatively uneventful postoperative course and was discharged to home on\npostoperative day 2. The patient required no postoperative adjuvant therapies. At the time\nof this publication—36 months after her previous open right partial nephrectomy—the patient\nis without evidence of disease.