Nuclear imaging of renal tumours: a step towards improved risk stratification

Abstract

Patients presenting with a clinically localized renal mass should ideally be managed with a risk-adapted approach that incorporates data regarding the metastatic potential of a given tumour. Unfortunately, currently available anatomical imaging techniques are unable to reliably distinguish between the various types of renal tumours, which include both benign and malignant histologies. Nuclear imaging offers a potential noninvasive means to characterize clinically localized renal tumours. A number of nuclear imaging tests are currently under investigation for this purpose and might one day be incorporated into patient care.

Computed Tomography Appearance of Renal Hybrid Oncocytic/Chromophobe Tumors

“…In the near future, it is likely that characterization of renal masses will rely on information from both traditional cross-sectional methods as well as more functional and metabolic aspects of the tumors. 22 …”

Characterization of indeterminate renal masses with molecular imaging: how do we turn potential into reality?

“…Moreover, it has been estimated that upwards of 5600 unnecessary partial and radical nephrectomies are performed each year in the USA for the false presumption of cancer [5]. In light of these data, recently, there has been a growing interest in the use of molecular imaging to characterize the aggressiveness of renal masses [6, 7]. …”

Defining the Added Value of 99mTc-MIBI SPECT/CT to Conventional Cross-Sectional Imaging in the Characterization of Enhancing Solid Renal Masses

“…7 In contrast, up to 20% of renal masses treated with nephrectomy are benign, with oncocytomas accounting for almost half of these lesions. 3,13 On conventional imaging, oncocytomas are difficult to differentiate from other renal tumor histologies despite the fact that approximately 50% of cases have a characteristic central stellate scar. 3,13 On conventional imaging, oncocytomas are difficult to differentiate from other renal tumor histologies despite the fact that approximately 50% of cases have a characteristic central stellate scar.…”

“…14,15 Nevertheless, this feature is not sufficiently specific to exclude RCC, as a central scar may be mistaken with a central necrosis of RCC. 3,17,18 The potential role of 99m Tc-MIBI planar imaging in identifying renal oncocytomas was first hypothesized in 1996 19 and recently expanded on in 2 subsequent studies. 3,17,18 The potential role of 99m Tc-MIBI planar imaging in identifying renal oncocytomas was first hypothesized in 1996 19 and recently expanded on in 2 subsequent studies.…”

“…3,17,18 The potential role of 99m Tc-MIBI planar imaging in identifying renal oncocytomas was first hypothesized in 1996 19 and recently expanded on in 2 subsequent studies. 3,18 Although 99m Tc-MIBI SPECT/ CT has been shown to aid in the differentiation of oncocytomas and HOCTs from other renal tumor histologies, 17 its added clinical value to conventional cross-sectional imaging has not been explored. 3,18 Although 99m Tc-MIBI SPECT/ CT has been shown to aid in the differentiation of oncocytomas and HOCTs from other renal tumor histologies, 17 its added clinical value to conventional cross-sectional imaging has not been explored.…”