MP64-08 ^99m TC- SESTAMIBI SPECT/CT FOR THE CHARACTERIZATION OF SMALL RENAL MASSES: INITIAL EXPERIENCE FROM a TERTIARY REFERRAL CENTER

You have accessJournal of UrologyCME1 Apr 2023MP64-08 99mTC- SESTAMIBI SPECT/CT FOR THE CHARACTERIZATION OF SMALL RENAL MASSES: INITIAL EXPERIENCE FROM a TERTIARY REFERRAL CENTER Alessandro Bertini, Francesco Cei, Chiara Re, Giacomo Musso, Giuseppe Rosiello, Giuseppe Fallara, Giuseppe Basile, Daniele Cignoli, Daniela Canibus, Gino Pepe, Luigi Gianolli, Francesco DE Cobelli, Giorgio Brembilla, Roberta Lucianò, Nazario Tenace, Rayan Matloob, Roberto Bertini, Alberto Briganti, Francesco Montorsi, Andrea Salonia, Alessandro Larcher, and Umberto Capitanio Alessandro BertiniAlessandro Bertini More articles by this author , Francesco CeiFrancesco Cei More articles by this author , Chiara ReChiara Re More articles by this author , Giacomo MussoGiacomo Musso More articles by this author , Giuseppe RosielloGiuseppe Rosiello More articles by this author , Giuseppe FallaraGiuseppe Fallara More articles by this author , Giuseppe BasileGiuseppe Basile More articles by this author , Daniele CignoliDaniele Cignoli More articles by this author , Daniela CanibusDaniela Canibus More articles by this author , Gino PepeGino Pepe More articles by this author , Luigi GianolliLuigi Gianolli More articles by this author , Francesco DE CobelliFrancesco DE Cobelli More articles by this author , Giorgio BrembillaGiorgio Brembilla More articles by this author , Roberta LucianòRoberta Lucianò More articles by this author , Nazario TenaceNazario Tenace More articles by this author , Rayan MatloobRayan Matloob More articles by this author , Roberto BertiniRoberto Bertini More articles by this author , Alberto BrigantiAlberto Briganti More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , Andrea SaloniaAndrea Salonia More articles by this author , Alessandro LarcherAlessandro Larcher More articles by this author , and Umberto CapitanioUmberto Capitanio More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003322.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Initial studies on 99mTc-Sestamibi Single Photon Emission Computed Tomography/Computed Tomography (SPECT/CT) on small renal masses (SMR) suggested its use to characterize renal oncocytoma (RO) from renal cell carcinoma (RCC). In this case series, we present the initial cases managed at our tertiary referral center. METHODS: We prospectively collected data on 40 consecutive patients with a SMR diagnosed at our institution and submitted to 99mTc- SPECT/CT at our Institution between May 2021 and September 2022. Of all, pathological data, either from biopsy or surgery, are available for 25 patients. We assessed the sensitivity (SE), specificity (SP), positive predictive value (PPV), negative predictive value (NPP) and the diagnostic accuracy (through the Area Under the roc Curve - AUC) of the 99mTc- SPECT/CT to differentiate oncocytoma and benign renal masses from malignant ones. RESULTS: Of 25 patients, 7 (28%) were females and 18 (72%) males. Median age at diagnosis was 64.9 (95% CI 57.1-72.1). Median max diameter at imaging was 3 cm (IQR 2.6-3.3). The SMR was diagnosed in 2 cases with the solely MRI (8%), in 12 cases with a CT scan (48%) and in 11 with both (44%). In 7 cases the SMR resulted positive at the 99mTc- SPECT/CT scan, suggesting a high-density mitochondrial tissue. 10 cases were submitted to biopsy and 15 to robotic partial nephrectomy. Of 10 biopsies, 2 SMRs were also treated with ablation and 1 which resulted positive for clear cell (cc)RCC was submitted to active surveillance. Overall, there were 9 oncocytomas, 8 ccRCC, 6 papillary tumors (of which 1 type I and 3 type II), 1 chronic nephritis and 1 cystic lesion with low probability of malignancy. Overall, for oncocytomas, SE was 55.5%, SP 87.5%, PPV 71.4% and NPV 77.8. The accuracy in differentiating oncocytomas from SMR of other nature was 74.6%. Considering all kind of benign SMRs, SE was 50%, SP 86.7%, PPV 71.4% and NPV 72.2%. The accuracy in differentiating benign from malignant SMR was 71.8%. CONCLUSIONS: Despite the relatively small sample size and the initial experience, 99mTc- SPECT/CT should be regarded as a promising, non-invasive technique with good accuracy in the detection of renal oncocytoma. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e883 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alessandro Bertini More articles by this author Francesco Cei More articles by this author Chiara Re More articles by this author Giacomo Musso More articles by this author Giuseppe Rosiello More articles by this author Giuseppe Fallara More articles by this author Giuseppe Basile More articles by this author Daniele Cignoli More articles by this author Daniela Canibus More articles by this author Gino Pepe More articles by this author Luigi Gianolli More articles by this author Francesco DE Cobelli More articles by this author Giorgio Brembilla More articles by this author Roberta Lucianò More articles by this author Nazario Tenace More articles by this author Rayan Matloob More articles by this author Roberto Bertini More articles by this author Alberto Briganti More articles by this author Francesco Montorsi More articles by this author Andrea Salonia More articles by this author Alessandro Larcher More articles by this author Umberto Capitanio More articles by this author Expand All Advertisement PDF downloadLoading ...