Prospective Evaluation of 99mTc-sestamibi SPECT/CT for the Diagnosis of Renal Oncocytomas and Hybrid Oncocytic/Chromophobe Tumors

Gorin, Michael A.; Rowe, Steven P.; Baras, Alexander S.; Solnes, Lilja B.; Ball, Mark W.; Pierorazio, Phillip M.; Pavlovich, Christian P.; Epstein, Jonathan I.; Javadi, Mehrbod S.; Allaf, Mohamad E.

doi:10.1016/j.eururo.2015.08.056

Cited by 142 publications

(136 citation statements)

References 10 publications

Supporting

Mentioning

127

Contrasting

Order By: Relevance

“…Based on tumour visual analysis, our data confirms the hypothesis that oncocytomas show uptake of 99m Tc-sestamibi, which is in accordance with the aforementioned studies [25, 27, 28] with a high true positive rate. In this pilot study, 11 out of 12 oncocytomas were sestamibi+, resulting in a 91.6% sensitivity of the method.…”

Section: Discussionsupporting

confidence: 91%

See 1 more Smart Citation

Visual evaluation and differentiation of renal oncocytomas from renal cell carcinomas by means of 99mTc-sestamibi SPECT/CT

et al. 2017

View full text Add to dashboard Cite

BackgroundDespite 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 99mTc-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 99mTc-sestamibi. Visual evaluation was performed, and any focal 99mTc-sestamibi uptake detected on SPECT in the localisation of tumour was considered as positive.ResultsEleven out of 12 oncocytomas (91.6%) displayed positive uptake of 99mTc-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 99mTc-sestamibi. The remaining 11 renal cell carcinomas were sestamibi negative.ConclusionsDifferentiation of benign renal oncocytomas from renal cell carcinomas seems very promising on 99mTc-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.

show abstract

Section: Discussionsupporting

confidence: 91%

“…However, the rationale behind the use of this imaging agent with another mechanism of uptake was not strong enough to support further use of DTPA for this reason. In this context, recent work from Rowe and Gorin supported the potential role of 99m Tc-sestamibi SPECT/CT in differentiating benign oncocytoma from RCC [27, 28]. …”

Section: Introductionmentioning

confidence: 98%

Visual evaluation and differentiation of renal oncocytomas from renal cell carcinomas by means of 99mTc-sestamibi SPECT/CT

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Our center is increasingly integrating clinical data, 22 with renal mass biopsy 23 and nuclear imaging data, 24 to better determine which patients may be spared from surgical resection. However, for many patients in this 12-year series, these methods were unavailable or infrequently used at the time of their diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Partial vs Radical Nephrectomy for T1-T2 Renal Masses in the Elderly: Comparison of Complications, Renal Function, and Oncologic Outcomes

An¹,

Ball²,

Gorin³

et al. 2017

Urology

Self Cite

View full text Add to dashboard Cite

OBJECTIVE To compare outcomes of partial nephrectomy (PN) and radical nephrectomy (RN) in patients 65 years and older. MATERIALS AND METHODS Our institutional renal mass registry was queried for patients 65 and older with solitary cT1–T2 renal mass resected by PN or RN. Clinicopathologic features and perioperative outcomes were compared between groups. Renal function outcomes measured by change in estimated glomerular filtration rate (eGFR) and freedom from eGFR< 45 mL/min/1.73 m2 were analyzed. Multivariate Cox proportional hazard models for overall survival and cancer-specific survival were analyzed. RESULTS Overall, 787 patients met inclusion criteria. Of these, 437 (55.5%) underwent PN and 350 (44.5%) underwent RN. Median follow-up was 36 months. Patients in the PN cohort were younger (median age 70.3 years vs 71.9 years, P < .001), had lower American Society of Anesthesiologists scores (2.6 vs 2.8, P = .001), smaller tumors (tumor diameter 2.8 cm vs 5.0 cm, P < .001), and lower proportion of renal cell carcinoma (76.7% vs 87.4%, P < .001). Perioperative outcomes were similar between PN and RN groups as were complications (37.8% vs 38.9%). Estimated change in eGFR was less in PN vs RN (6.4 vs 19.7, P < .001) at last follow-up. Overall survival and cancer-specific survival were equivalent between modalities. CONCLUSION Because the renal functional benefit of PN is realized over many years and the procedure has a higher historical complication rate than RN, some suspected elderly patients might benefit more from RN over PN. However, these data suggest that elderly patients are not harmed and may potentially benefit from PN. Age alone should not be a contraindication to nephron-sparing surgery.

show abstract

“…Nonetheless, it is important for practicing radiologists to be aware of the existence of HOCTs and other benign/indolent renal masses that can mimic aggressive tumors. This is because promising, new, noninvasive means of characterizing renal masses are beginning to appear in the literature at both the preclinical 18 and early clinical 19–21 stages of development. 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.…”

Section: Discussionmentioning

confidence: 99%

Computed Tomography Appearance of Renal Hybrid Oncocytic/Chromophobe Tumors

Bhatnagar

Rowe²,

Gorin³

et al. 2016

Journal of Computer Assisted Tomography

Self Cite

View full text Add to dashboard Cite

Objective A series of renal hybrid oncocytic/chromophobe tumors (HOCTs) was retrospectively assessed for morphologic features and enhancement characteristics by computed tomography (CT). Materials (Subjects) and Methods Nine patients with pathologically proven HOCTs were identified. These patients harbored a total of 12 lesions. All patients had available preoperative contrast-enhanced CT examinations, although a proportion of the studies had been carried out at outside institutions. The morphologic characteristics and enhancement patterns of each tumor were evaluated systematically. Results Seventy-eight percent of the patients were men, with a mean age of 62 years. None of the patients had evidence of metastatic disease at the time of surgery. Mean tumor diameter was 4.4 cm. All the lesions were solid and well circumscribed. Calcifications were not seen in any of these masses. Thirty-three percent of the tumors demonstrated a central stellate hypodensity pattern, whereas a further 42% of the tumors demonstrated a heterogenous appearance. Mean attenuation values were 25.7 HU (noncontrast), 77.4 HU (arterial), 124.8 HU (venous), and 76.8 HU (delayed). Tumor-to-cortex ratios for the 2 enhanced phases (arterial and venous) were 0.56 and 0.79, respectively. Conclusions A series of HOCTs were found on CT to have 2 distinct patterns—a heterogenous enhancement pattern and an “oncocytoma-like” pattern with a central stellate hypodensity. Although the prospective diagnosis of HOCTs on the basis of CT findings is unlikely, an awareness of the existence of these lesions is important as new means of characterizing renal masses on imaging arise.

show abstract

Prospective Evaluation of 99mTc-sestamibi SPECT/CT for the Diagnosis of Renal Oncocytomas and Hybrid Oncocytic/Chromophobe Tumors

Cited by 142 publications

References 10 publications

Visual evaluation and differentiation of renal oncocytomas from renal cell carcinomas by means of 99mTc-sestamibi SPECT/CT

Visual evaluation and differentiation of renal oncocytomas from renal cell carcinomas by means of 99mTc-sestamibi SPECT/CT

Partial vs Radical Nephrectomy for T1-T2 Renal Masses in the Elderly: Comparison of Complications, Renal Function, and Oncologic Outcomes

Computed Tomography Appearance of Renal Hybrid Oncocytic/Chromophobe Tumors

Contact Info

Product

Resources

About