99m Tc-Sestamibi SPECT/CT and histopathological features of oncocytic renal neoplasia.

Autor: Tzortzakakis A; Division of Radiology, Department for Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Solna, Sweden.; Medical Radiation Physics and Nuclear Medicine, Functional Unit of Nuclear Medicine, Karolinska University Hospital, Huddinge, Sweden., Papathomas T; Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, United Kingdom.; Gloucestershire Cellular Pathology Laboratory, Cheltenham General Hospital, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, United Kingdom., Gustafsson O; Division of Urology, Karolinska University Hospital, Huddinge, Sweden., Gabrielson S; Division of Radiology, Department for Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Solna, Sweden.; Medical Radiation Physics and Nuclear Medicine, Functional Unit of Nuclear Medicine, Karolinska University Hospital, Huddinge, Sweden., Trpkov K; Department of Pathology and Laboratory Medicine, Alberta Precision Labs, Cumming School of Medicine, University of Calgary, Calgary, Canada., Ekström-Ehn L; Division of Urology, Karolinska University Hospital, Huddinge, Sweden., Arvanitis A; Department of Clinical Pathology and Cytology, Karolinska University Hospital, Huddinge, Stockholm, Sweden., Holstensson M; Medical Radiation Physics and Nuclear Medicine, Functional Unit of Nuclear Medicine, Karolinska University Hospital, Huddinge, Sweden.; Division of Function and Technology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet., Karlsson M; Medical Radiation Physics and Nuclear Medicine, Functional Unit of Nuclear Medicine, Karolinska University Hospital, Huddinge, Sweden., Kokaraki G; Division of Radiology, Department for Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Solna, Sweden.; Department of Clinical Pathology and Cytology, Karolinska University Hospital, Huddinge, Stockholm, Sweden., Axelsson R; Division of Radiology, Department for Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Solna, Sweden.; Medical Radiation Physics and Nuclear Medicine, Functional Unit of Nuclear Medicine, Karolinska University Hospital, Huddinge, Sweden.
Jazyk: angličtina
Zdroj: Scandinavian journal of urology [Scand J Urol] 2022 Oct-Dec; Vol. 56 (5-6), pp. 375-382. Date of Electronic Publication: 2022 Sep 05.
DOI: 10.1080/21681805.2022.2119273
Abstrakt: Background: 99m Tc-Sestamibi Single Photon Emission Computed Tomography/Computed Tomography (SPECT/CT) contributes to the non-invasive differentiation of renal oncocytoma (RO) from renal cell carcinoma (RCC) by characterising renal tumours as Sestamibi positive or Sestamibi negative regarding their 99m Tc-Sestamibi uptake compared to the non-tumoral renal parenchyma.
Purpose: To determine whether 99m Tc- Sestamibi uptake in renal tumour and the non-tumoral renal parenchyma measured using Standard Uptake Value (SUV) SPECT, has a beneficial role in differentiating RO from RCC.
Material and Methods: Fifty-seven renal tumours from 52 patients were evaluated. In addition to visual evaluation of 99m Tc-Sestamibi uptake, SUV max measurements were performed in the renal tumour and the ipsilateral non-tumoral renal parenchyma. Analysis of the area under the receiver operating characteristic curve identified an optimal cut-off value for detecting RO, based on the relative ratio of 99m Tc- Sestamibi uptake.
Results: Semiquantitative evaluation of 99m Tc-Sestamibi uptake did not improve the performance of 99m Tc- Sestamibi SPECT/CT in detecting RO. 99m Tc- Sestamibi SPECT/CT identifies a group of mostly indolent Sestamibi-positive tumours with low malignant potential containing RO, Low-Grade Oncocytic Tumours, Hybrid Oncocytic Tumours, and a subset of chromophobe RCCs.
Conclusion: The imaging limitations for accurate differentiation of Sestamibi-positive renal tumours mirror the recognised diagnostic complexities of the histopathologic evaluation of oncocytic neoplasia. Patients with Sestamibi-positive renal tumours could be better suited for biopsy and follow-up, according to the current active surveillance protocols.
Databáze: MEDLINE
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