Diagnostic Accuracy of Tc99m-Sestamibi in Differentiating Benign vs Malignant Renal Masses

Zeeshan Sikandar; Fida Hussain; Zaigham Salim Dar; Rebecca Sharoon; Aleena Tariq; Muhammad Usman Ibrahim

doi:10.51253/pafmj.v75i5.10913

Authors

Zeeshan Sikandar Department of Nuclear Medicine, Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Fida Hussain Department of Nuclear Medicine, Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Zaigham Salim Dar Department of Nuclear Medicine, Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Rebecca Sharoon Department of Nuclear Medicine, Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Aleena Tariq Department of Nuclear Medicine, Rawalpindi Medical University (RMU), Rawalpindi Pakistan
Muhammad Usman Ibrahim Department of Nuclear Medicine, Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS), Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v75i5.10913

Keywords:

Oncocytoma, Renal Cell Carcinoma, SPECT/CT, Tc-99m Sestamibi

Abstract

Objective: To assess the role of pre-operative Tc-99m sestamibi scintigraphy in Differentiating Benign vs Malignant Renal Masses.

Study Design: Cross-sectional study

Place and Duration of Study: Nuclear Medical Centre, Armed Forces Institute of Pathology, Rawalpindi Pakistan, from Jun 2022 to Jun 2023.

Methodology: A total of 41 patients with T1 solid renal tumours who were eligible for undergoing surgery or suitable for biopsy underwent Tc-99m sestamibi scintigraphy during study duration. Tc-99m sestamibi scintigraphy findings were correlated with post-operative histopathology results to determine accuracy of scintigraphic study.

Results: Out of forty-one patients, 24(58.5%) were men and 17(41.5%) were women with a mean age 54.39±13.28 years. Among total patients, 24(58.5%) had clear cell RCC, 5(12.2%) had papillary RCC, 3(7.3%) had chromophobe RCC, 2(4.9%) had oncocytic papillary RCC, 5(12.2%) had oncocytoma and 2(4.9%) had lipid poor angiomyolipoma variant on histopathology. Overall, 7(17.07%) patients had benign pathology. Tc-99m Sestamibi SPECT/CT correctly identified all benign lesions (oncocytoma and lipid poor angiomyolipoma) and two variants of malignant pathology (chromophobe and oncocytic papillary RCC) yielding a sensitivity of 100% while specificity of 85.29% in detecting benign lesions. There was significant correlation between positive Tc-99m sestamibi findings and benign pathology with a p-value <0.001.

Conclusions: Tc-99m sestamibi scintigraphy plays a significant role in pre-operative evaluation of renal masses and offers a non-invasive modality to help differentiate benign and malignant renal masses.

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