Imaging of Chromophobe Renal Cell Carcinoma with 99m Tc-Sestamibi SPECT/CT: Considerations Regarding Risk Stratification and Histologic Reclassification.

Autor: Rowe SP; Molecular Imaging and Therapeutics, Department of Radiology, University of North Carolina, 101 Manning Dr, Chapel Hill, NC, 27514, USA. steven_rowe@med.unc.edu., Murtazaliev S; Department of Medical Imaging, The University of Arizona College of Medicine, Tuscon, AZ, USA., Oldan JD; Molecular Imaging and Therapeutics, Department of Radiology, University of North Carolina, 101 Manning Dr, Chapel Hill, NC, 27514, USA., Kaufmann B; Milton and Carroll Petrie Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Khan A; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA., Allaf ME; The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA., Singla N; The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA., Pavlovich CP; The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA., De Marzo AM; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA., Baraban E; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA., Gorin MA; Milton and Carroll Petrie Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Solnes LB; The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Jazyk: angličtina
Zdroj: Molecular imaging and biology [Mol Imaging Biol] 2024 Oct; Vol. 26 (5), pp. 768-773. Date of Electronic Publication: 2024 Jul 29.
DOI: 10.1007/s11307-024-01938-6
Abstrakt: Purpose: Indeterminate renal masses are increasingly incidentally found on cross-sectional imaging. 99m Tc-sestamibi single-photon emission computed tomography/computed tomography (SPECT/CT) scans can be used to identify oncocytomas and oncocytic renal neoplasms, including a subset of chromophobe renal cell carcinomas (chRCCs), which are viewed as false-positive.
Procedure: Patients imaged with renal sestamibi scans between 2014 and 2023 were reviewed. Those patients with solitary tumors that were originally classified as chRCC were included in the analysis. Imaging with SPECT/CT from the liver dome down had been carried out 75 min after the administration of 925 MBq of 99m Tc-sestamibi. All available H&E and immunostained slides were re-reviewed and classified according to WHO 2022 criteria. Confirmatory immunohistochemical stains were performed in tumors considered morphologically suspicious for non-chRCC entities.
Result: A total of 18 patients with solitary tumors were included in the final analysis. 13/18 (72.2%) tumors in this cohort remained classified as chRCC, with 4/18 (22.2%) being eosinophilic-variant chRCC. The reclassified tumors (5/18 [27.8%]) included 2/18 (11.1%) low-grade oncocytic tumor (LOT), 1/18 (5.5%) eosinophilic vacuolated tumor (EVT), and 2/18 (11.1%) unclassified low-grade oncocytic neoplasms. As such, only 2/9 (22.2%) qualitatively "hot" tumors were chRCC other than eosinophilic-variant and only 1/9 (11.1%) "cold" tumors was a histology other than chRCC.
Conclusion: Based on current histopathologic classification methods, it is likely that the "false-positive" rate of uptake on renal sestamibi scans with chRCC has been over-stated. Further study is warranted to better refine the optimal utility of renal sestamibi scans for non-invasive risk stratification of indeterminate renal masses.
(© 2024. The Author(s), under exclusive licence to World Molecular Imaging Society.)
Databáze: MEDLINE
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