Molecular Imaging of Renal Malignancy: A Review
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Purpose of Review
Renal cell carcinoma (RCC) is a common malignancy that is often detected incidentally in patients undergoing cross-sectional imaging of the abdomen for workup of pain or other symptoms. Due to overlap in imaging findings of RCC and benign tumors, biopsy may be necessary to confirm the diagnosis. Biopsies are occasionally non-diagnostic, however, and in small lesions or patients with comorbidities may not be technically feasible. Molecular imaging techniques can characterize tumors as being more likely malignant or benign and obviate the need for invasive testing, as well as providing accurate whole-body staging in patients with known RCC.
PET/CT with 18F-FDG and other radionuclides can identify primary renal masses with higher malignant potential and also allows for sensitive detection of metastatic RCC. SPECT/CT imaging with 99mTc-sestamibi can provide useful information to support the diagnosis of benign oncocytic neoplasms over more aggressive RCC subtypes. Investigational molecular imaging techniques such as immunoPET and hyperpolarized 13C MRI have also shown promise in renal mass characterization.
This review article aims to outline the various molecular imaging modalities available in the evaluation of primary renal tumors and in whole-body staging of metastatic RCC.
KeywordsRCC Renal cell carcinoma FDG PET PET/CT Molecular imaging
The authors acknowledge Dr. Steven Rowe for contributing the cases as shown in Fig. 4.
Compliance with Ethics Guidelines
Conflict of interest
Spencer C. Behr reports grants from Cancer Targeted Technology and GE Healthcare and is a consultant for QED Therapeutics. Robert R. Flavell is a section editor for Current Radiology Reports. C. Elias Graybiel and Zhen J. Wang each declare no potential conflicts of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
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