Nuclear i
maging offers a potential noninvasive
means of deter
mining the histology of renal tu
mors. The ai
m of this study was to evaluate the accuracy of technetiu
m-99
m (
99mTc)–sesta
mibi single-photon e
mission co
mputed to
mography/x-ray co
mputed to
mography (SPECT/CT) for the differentiation of oncocyto
mas and hybrid oncocytic/chro
mophobe tu
mors (HOCTs) fro
m other renal tu
mor histologies. In total, 50 patients with a solid clinical T1 renal
mass were i
maged with
99mTc-sesta
mibi SPECT/CT prior to surgical resection. Preoperative SPECT/CT scans were reviewed by two blinded readers, and their results were co
mpared with centrally reviewed surgical pathology data. Following surgery, 6 (12%) tu
mors were classified as renal oncocyto
mas and 2 (4%) as HOCTs. With the exception of 1 (2%) angio
myolipo
ma, all other tu
mors were renal cell carcino
mas (82%).
99mTc-sesta
mibi SPECT/CT correctly identified 5 of 6 (83.3%) oncocyto
mas and 2 of 2 (100%) HOCTs, resulting in an overall sensitivity of 87.5% (95% confidence interval [CI], 47.4&
minus;99.7%). Only two tu
mors were falsely positive on SPECT/CT, resulting in a specificity of 95.2% (95% CI, 83.8&
minus;99.4%). In su
mmary,
99mTc-sesta
mibi SPECT/CT is a pro
mising i
maging test for the noninvasive diagnosis of renal oncocyto
mas and HOCTs.
Patient summary
We found that the imaging test 99mTc-sestamibi SPECT/CT can be used to accurately diagnose two types of benign kidney tumors. This test may be eventually used to help better evaluate patients diagnosed with a renal tumor.