The latest in a series of studies led by researchers at Johns Hopkins Medicine shows that addition of a widely available, noninvasive imaging test called 99mTc-sestamibi SPECT/CT to CT or MRI increases the accuracy of kidney tumor classification. The research team reports that the potential improvement in diagnostic accuracy will spare thousands of patients each year in the United States alone from having to undergo unnecessary surgery.
Test adds additional diagnostic information
In a recent report on ongoing work to improve kidney tumor classification, published in the April issue of the journal Clinical Nuclear Medicine, the team reports that the sestamibi SPECT/CT test—short for 99mTc-sestamibi single-photon emission computed tomography/computed tomography(CT) — adds additional diagnostic information in conjunction with conventional CTs and MRI and improves physicians’ ability to differentiate between benign and malignant kidney tumors.
This noninvasive scan may prevent patients
“Sestamibi SPECT/CT lets radiologists and urologists ‘see’ the most common benign kidney tumor, something CT and MRI have not succeeded in doing alone,” says Mohamad E. Allaf, M.D., MEA Endowed Professor of Urology at the Johns Hopkins University School of Medicine. “This noninvasive scan may prevent patients with a potentially benign kidney tumor from having to undergo a surgery to remove the tumor or potentially the entire kidney, along with its associated risks and high costs. At Johns Hopkins, use of this test has already spared a number of our patients from unnecessary surgery and unnecessary removal of a kidney that would require them to be on dialysis. These results are hugely encouraging, but we need to do more studies.”
Addition of sestamibi SPECT/CT increased physicians’ ability
Even for patients whose tumors were not reclassified, the addition of sestamibi SPECT/CT increased physicians’ ability to more confidently classify malignant tumors, which reduces the risk of misdiagnosis and unnecessary surgery for all patients, the researchers say. Radiologists and urologists have been frustrated for decades by the inability of conventional imaging tests, such as CT and MRI, to distinguish benign from malignant kidney tumors. At Johns Hopkins, multispecialty teams work together to determine the best care for patients and as partners on research innovations and quality improvement initiatives.
Struggled to find noninvasive ways
“As radiologists, we have struggled to find noninvasive ways to better classify patients and spare unnecessary surgery, but this has not been easy,” says Steven P. Rowe, M.D., Ph.D., one of the two former residents who developed this approach, and now assistant professor of radiology and radiological science at the Johns Hopkins University School of Medicine. “Sestamibi SPECT/CT offers an inexpensive and widely available means of better characterizing kidney tumors, and the identical test is now being performed as part of a large trial in Sweden, for which the first results have just recently been published and appear to confirm our conclusions.”