Faculty Collaboration Database

Use of quantitative SPECT/CT reconstruction in ^99mTc-sestamibi imaging of patients with renal masses. Ann Nucl Med 2018 Feb;32(2):87-93

Date

12/08/2017

Pubmed ID

29214562

DOI

10.1007/s12149-017-1222-z

Scopus ID

2-s2.0-85037088572 (requires institutional sign-in at Scopus site)   15 Citations

Abstract

OBJECTIVE: Technetium-99m (^99mTc)-sestamibi single-photon emission computed tomography/computed tomography (SPECT/CT) has previously been shown to allow for the accurate differentiation of benign renal oncocytomas and hybrid oncocytic/chromophobe tumors (HOCTs) apart from other malignant renal tumor histologies, with oncocytomas/HOCTs showing high uptake and renal cell carcinoma (RCC) showing low uptake based on uptake ratios from non-quantitative single-photon emission computed tomography (SPECT) reconstructions. However, in this study, several tumors fell close to the uptake ratio cutoff, likely due to limitations in conventional SPECT/CT reconstruction methods. We hypothesized that application of quantitative SPECT/CT (QSPECT) reconstruction methods developed by our group would provide more robust separation of hot and cold lesions, serving as an imaging framework on which quantitative biomarkers can be validated for evaluation of renal masses with ^99mTc-sestamibi.

METHODS: Single-photon emission computed tomography data were reconstructed using the clinical Flash 3D reconstruction and QSPECT methods. Two blinded readers then characterized each tumor as hot or cold. Semi-quantitative uptake ratios were calculated by dividing lesion activity by background renal activity for both Flash 3D and QSPECT reconstructions.

RESULTS: The difference between median (mean) hot and cold tumor uptake ratios measured 0.655 (0.73) with the QSPECT method and 0.624 (0.67) with the conventional method, resulting in increased separation between hot and cold tumors. Sub-analysis of 7 lesions near the separation point showed a higher absolute difference (0.16) between QPSECT and Flash 3D mean uptake ratios compared to the remaining lesions.

CONCLUSIONS: Our finding of improved separation between uptake ratios of hot and cold lesions using QSPECT reconstruction lays the foundation for additional quantitative SPECT techniques such as SPECT-UV in the setting of renal ^99mTc-sestamibi and other SPECT/CT exams. With robust quantitative image reconstruction and biomarker analysis, there may be an expanded role for SPECT/CT imaging in renal masses and other pathologic conditions.

Author List

Jones KM, Solnes LB, Rowe SP, Gorin MA, Sheikhbahaei S, Fung G, Frey EC, Allaf ME, Du Y, Javadi MS

MESH terms used to index this publication - Major topics in bold

Adenoma, Oxyphilic
Adult
Aged
Aged, 80 and over
Diagnosis, Differential
Female
Humans
Imaging, Three-Dimensional
Kidney Neoplasms
Male
Middle Aged
Single Photon Emission Computed Tomography Computed Tomography
Technetium Tc 99m Sestamibi