In parallel to the increased utilization of cross-sectional imaging, the incidence of small renal masses has steadily risen in recent years. At the present time, anatomical imaging techniques are limited in their ability to differentiate benign from malignant renal masses. Moreover, renal mass biopsy has a high non-diagnostic rate, poor negative predictive ability, and carries potential risks as well as substantial costs. As a result, benign renal masses are often unnecessarily resected for the false presumption of cancer. 99mTc-sestamibi SPECT/CT is a molecular imaging test that allows for the differentiation of benign renal oncocytomas and hybrid oncocytomic/chromophobe tumors apart from malignant renal cell carcinomas on the basis of differences in mitochondrial content as well as multi-drug resistant pump expression. Herein, we review the principles of 99mTc-sestamibi SPECT/CT administration and image interpretation for the purpose of renal mass characterization.
The British journal of radiology. 2017 Dec 22 [Epub ahead of print]
Scott P Campbell, Antonios Tzortzakakis, Mehrbod S Javadi, Mattias Karlsson, Lilja B Solnes, Rimma Axelsson, Mohamad E Allaf, Michael A Gorin, Steven P Rowe
1 The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA., 2 Imaging and Function, Karolinska University Hospital and Department of Clinical Science, Intervention, and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden., 3 The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA., 4 Imaging and Function, Medical Physics and Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden., 5 Imaging and Function, Medical Physics and Nuclear Medicine, Karolinska University Hospital and Department of Clinical Science, Intervention, and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.