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Visual evaluation and differentiation of renal oncocytomas from renal cell
carcinomas by means of (99m)Tc-sestamibi SPECT/CT
#MMPMID28357787
Tzortzakakis A
; Gustafsson O
; Karlsson M
; Ekström-Ehn L
; Ghaffarpour R
; Axelsson R
EJNMMI Res
2017[Dec]; 7
(1
): 29
PMID28357787
show ga
BACKGROUND: Despite the progress in the quality of multiphasic CT and MRI scans,
it is still difficult to fully characterize a solid kidney lesion. Approximately
10% of all solid renal tumours turn out to be oncocytomas. In actual clinical
practice, this is verified only following unnecessary surgery or a renal
biopsy/ablation. The objective of our pilot study examines whether
(99m)Tc-sestamibi SPECT/CT can play a crucial role in the characterization of
solid renal neoplasms and the differentiation of oncocytomas from renal cell
carcinomas. The study included 27 patients identified with 31 solid renal
lesions. All patients were discussed in a multidisciplinary conference, and a
decision for surgery or biopsy was taken. Prior to invasive procedures, patients
underwent a SPECT/CT with (99m)Tc-sestamibi. Visual evaluation was performed, and
any focal (99m)Tc-sestamibi uptake detected on SPECT in the localisation of
tumour was considered as positive. RESULTS: Eleven out of 12 oncocytomas (91.6%)
displayed positive uptake of (99m)Tc-sestamibi. Three hybrid tumours (mixed-type
oncocytoma and chromophobe renal cancer) were positive on SPECT/CT. One papillary
renal cell carcinoma had a slight uptake of (99m)Tc-sestamibi. The remaining 11
renal cell carcinomas were sestamibi negative. CONCLUSIONS: Differentiation of
benign renal oncocytomas from renal cell carcinomas seems very promising on
(99m)Tc-sestamibi SPECT/CT examination. Additional supplement to visual
evaluation, i.e. quantitative tools, should be sought for an accurate estimate of
biological behaviour and hence a secure diagnosis.