One Tracer, Whole Syndrome: CAIX-Targeted PET Unmasks the Multisystem Tumor Landscape of Von Hippel-Lindau Disease.
Esra Arslan, Halil Kömek, Canan Can et al.
✦ AI-curated · Sources linked
Case in brief
A 50-year-old man with von Hippel–Lindau disease underwent multimodal imaging to assess residual central nervous system disease. ⁶⁸Ga-DOTATATE PET/CT showed one cerebellar lesion, and ¹⁸F-FDG PET/CT was negative despite active disease. In contrast, [⁶⁸Ga]Ga-DPI-4452 PET/CT, targeting carbonic anhydrase IX (CAIX), depicted cerebellar and spinal hemangioblastomas, recurrent and contralateral clear cell renal cell carcinoma lesions, and epididymal involvement. The report illustrates how CAIX-targeted imaging revealed multisystem tumor burden not shown by the other PET studies.
What made this case unusual
CAIX-targeted PET/CT depicted widespread VHL-associated lesions despite negative ¹⁸F-FDG PET/CT and a single lesion on ⁶⁸Ga-DOTATATE PET/CT.
Diagnostic / clinical pearl
In this patient with VHL, CAIX-targeted PET/CT visualized multisystem disease that was not apparent on ¹⁸F-FDG PET/CT; imaging choice can affect the apparent extent of tumor burden.